Results of a program to prevent medication errors in a pediatric emergency department

Background and objective: Drug prescription errors are a significant cause of preventable morbidity and mortality in children. Our aim was to assess whether the frequency of medication error decreased after a prevention program was implemented in a pediatric emergency department. Material and methods: Observational pre- and postintervention study. We identified errors made in November 2009 (preintervention period) by reviewing patient records. Errors were classified by type (dose, indication, route of administration), level of seriousness (low, moderate, high), and associated factors (staff experience, seriousness of the emergency, day of the week, hour of the day). In 2010 sessions to provide information about the detected errors were held and informative posters were hung in the department. Errors were again identified in November 2010 (postintervention period) and the results were compared. Results: Errors were made most often with bronchodilators, corticosteroids, and anti-inflammatory drugs. In the first period, out of 445 prescriptions made, 49 errors (11%) were detected; in the second period, 48 errors in 557 prescriptions (8.6%) were detected. The difference was not significant. The rate of dosage error decreased significantly between the 2 periods (7.4% vs 3.8%, P=.016), but we saw no significant changes in incorrect indication, choice of route of administration, or seriousness. During the postintervention period, fewer errors were made in the most serious emergencies (11.6% vs 5.7%; P=.005) and between midnight and 8 a.m. (16.2% vs 6.1%; P=.02). Conclusions: The error prevention program allowed us to reduce some types of medication error but follow-up and continued insistence on vigilance is required. [Emergencias 2012;24:91-95]