Assessing for preparation and administration errors: a prospective observation study of paediatric resuscitation simulations
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Date
2018
Authors
Murugan, Sashen
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Abstract
Introduction
Very few studies have assessed drug preparation and administration errors during
paediatric resuscitation. Current evidence suggests that medication errors in paediatrics
is a serious problem. The aim of this study was to evaluate drug preparation and
administration errors incurred during the simulated resuscitation of paediatric patients.
Methods
This was a prospective observational study performed in the emergency department of
a tertiary level hospital . Teams consisting of two emergency doctors were tasked with
preparing and delivering medication during simulated emergency scenarios. Preparation
processes were video recorded. All vials, syringes and administered volumes were
collected and analysed to determine the accuracy of drug preparation and delivery.
Deviations from intended volumes were calculated.
Main Results
A total of 96 dosages were recorded from 24 participants. Most errors were identified in
the withdrawal of drugs phase (prior to dilution) (13 of 95 doses had a >20% error), and
the administration of medications phase (20 of 96 doses had a >20% error). Overall the
median time taken to deliver each drug was 79 seconds (IQR 59, 100 seconds). The
largest percentage errors were seen when a large syringe was used to withdraw or
administer a small volume of medication.
Conclusion
The study clearly demonstrated that there were significant errors in the preparation and
administration of medication. Training in the preparation and administration of paediatric
medications should be available for all emergency nurses and doctors. Correct syringe
choice may reduce these errors. Smaller syringes should be used for withdrawing or
administering smaller volumes.
Description
Division of Emergency Medicine,
Faculty of Health Sciences,
University of Witwatersrand, Johannesburg, South Africa