Medication Errors In Pediatric Essay

Medication Errors in Pediatrics
The purpose of this paper is to show most of medication errors occur on the night shifts and the weekend shifts in pediatric care, Bar Code Medication Administration System’s success on extremely low medication errors in pediatric care, and tenfold medication errors in pediatric care.
What Is a Medication Error?
A medication error is any preventable event that may cause or lead to inappropriate medication use or harm to a patient (NCCMERP 2014). The death rate for medication errors averages around 7,000 deaths per year. Lawsuits for medication errors were mainly made against registered nurses because nurses are the last people to check a medication before it is administered. 426 medication error related lawsuits were made against registered nurses. (RightDiagnosis 2014).

Night and Weekend Shifts
First, medication errors mostly occur on night shifts and weekend shifts in pediatric

care. In this study the children’s hospital had two nursing shifts, from 0700-1859 for first shift, and 1900-0659 for second shift. The nurse-to-patient ratio averaged: general pediatrics 1:4, oncology 1:4, pediatrics ICU 1:2, and neonatal ICU 1:2 to 1:4. Pharmacist and pharmacy techs per shift and day of week is different and has three shifts, 0700-1459 for first shift, 1500-2159 for second shift, and 2200-0659 for third shift. Weekday staffing for pharmacists and pharmacy techs: 2 pharmacists and 4 technicians for first shift, 1 pharmacist and 1 technician for second shift, and 3 pharmacists and 3 technicians for third shift. Weekend staffing for pharmacists and pharmacy techs: 1 pharmacist and 2 technicians for first shift, 1 pharmacist and 1 technician for second shift, third shift are processed through the main hospital. As you can see the nurse-to-patient ratio is averagely normal, but understaffed on pharmacists and pharmacy techs during night shifts and the weekend shifts. Error rates compared by shift and day of the week on errors/1000 doses: Nursing: first shift 1.17, second shift 2.12; Pharmacy: first shift 1.01, second shift 2.24, third shift 1.88; Day of the week: weekday 1.9, weekend 2.55. As shown above with statistics from this study, most of the medication errors in this study occurred on night shifts and on the weekends instead of day shifts and during the week. (Miller, etal 2010).

Bar Code Medication Administration System
Next, the Bar Code Medication Administration System has been proven to lower medication errors extremely down to have a 95% success rate in pediatric care.

The Medication Administration Accuracy Project is a quality improvement project, whose purpose is to improve the accuracy of nursing medication administration. The study used for this project was to find where the most common “wrong doings” happened in the medication process and how to get rid of it. After a year of this project the medication error percent went from 4.3% in 2010 to 1.2% in 2011. The Bar Code Administration System implementation had been very successful with a 95% success rate every year that it is done. The study provided important insight on reducing the medication errors in children. Some were: making sure there are no distractions as possible, double checking medications and making sure the dose in adequate range for the child, and making sure you have two ways of identification with the bar code scanning (Hardmeier, A., Tsourounis, C., Moore, M., Abbott, W., Guglielmo, J.

2014).
Ten-Fold Medication Errors
Lastly, 10-fold medication errors are one of the most common medication errors occurring in pediatrics. A ten-fold medication error is any error that resulted from prescribing, mixing, dispensing, or administering of any medication at 10 times greater or lower than the accepted upper limits of safety. The most common point during the medication process where 10-fold medication error occurred was prescribing. High-risk medications for these errors were digoxin, insulin, heparin, and all forms of single-agent opioid analgesics. Antimicrobials were the second most reported drug class on 10-fold medication errors that were underdose. Another reason for some of these errors were because of incorrect programming of drug delivery equipment, especially intravenous pumps (Doherty, C., & McDonnell, C. 2012).

Conclusion
Medication errors occur on night shift and weekend shifts in pediatric care, Bar Code Medication Administration System’s success on extremely low medication errors in pediatric care, and tenfold medication errors in pediatric care are the most commons ways of the medication errors in pediatrics. A suggestion on fixing these errors are having mandatory programs every several months on ways to prevent such medication errors.