Incidence, characteristics, and predictive factors for medication errors in paediatric anaesthesia: a prospective incident monitoring study

Br J Anaesth. 2018 Mar;120(3):563-570. doi: 10.1016/j.bja.2017.12.014. Epub 2018 Feb 1.

Abstract

Background: Medication errors are not uncommon in hospitalized patients. Paediatric patients may have increased risk for medication errors related to complexity of weight-based dosing calculations or problems with drug preparation and dilution. This study aimed to determine the incidence of medication errors in paediatric anaesthesia in a university paediatric hospital, and to identify their characteristics and potential predictive factors.

Methods: This prospective incident monitoring study was conducted between November 2015 and January 2016 in an exclusively paediatric surgical centre. Children <18 yr undergoing general anaesthesia were consecutively included. For each procedure, an incident form was completed by the attending anaesthetist on an anonymous and voluntary basis.

Results: Incident forms were completed in 1400 (73%) of the 1925 general anaesthetics performed during the study period with 37 reporting at least one medication error (2.6%). Drugs most commonly involved in medication errors were opioids and antibiotics. Incorrect dose was the most frequently reported type of error (n=27, 67.5%), with dilution error involved in 7/27 (26%) cases of incorrect dose. Duration of procedure >120 min was the only factor independently associated with medication error [adjusted odds ratio: 4 (95% confidence interval: 2-8); P=0.0001].

Conclusions: Medication errors are not uncommon in paediatric anaesthesia. Identification of the mechanisms related to medication errors might allow preventive measures that can be assessed in further studies.

Keywords: anaesthesia; errors; general; medication; paediatrics.

MeSH terms

  • Anesthesia, General / adverse effects*
  • Anesthesia, General / statistics & numerical data
  • Child
  • Child, Preschool
  • Female
  • France / epidemiology
  • Hospitals, Pediatric
  • Hospitals, Teaching
  • Humans
  • Incidence
  • Infant
  • Male
  • Medication Errors / statistics & numerical data*
  • Pediatrics / methods*
  • Pediatrics / statistics & numerical data
  • Prospective Studies
  • Risk Management / methods*
  • Risk Management / statistics & numerical data