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Preventing Medication Errors
Preparation and Dispensing of the Drug
The committee identified only four studies addressing errors associated with the preparation and dispensing of medications in hospital pediatric care (see Table C-19). One study was based on chart reviews, which make it difficult to detect dispensing errors, particularly if errors are recognized and corrected before medication is given to the patient (Kaushal et al., 2001). This study estimated the rate of dispensing errors to be 0.05 errors per order written, or 5 dispensing errors per 1,000 patients.
Three other studies examined the proportion of dispensing errors among all reported medication errors. Estimates of this proportion vary widely: 4.5 percent for all types of medication in an inpatient setting (King et al., 2003), 9.3 percent for chemotherapy in an inpatient setting (France et al., 2004), and 58.9 percent for all types of medication in an ICU (Frey et al., 2002).
Administration of the Drug
Rates of drug administration errors have been reported in varying ways (see Table C-20). Administration errors were estimated to be 0.72 errors per 100 orders (or 7 per 100 admissions, or 19.8 per 1,000 patient-days) for all types of medication in an inpatient setting (Kaushal et al., 2001); 23
TABLE C-19 Hospital Pediatric Care: Preparation and Dispensing Errors
Errors per 1,000 patients—detection method
5 (Kaushal et al., 2001)—chart review
Proportion of dispensing errors among all medication errors
Percentage of reported errors related to dispensing—detection method
4.5 percent (inpatient setting) (King et al., 2003)—incident reports