Document Detail


Medication errors in the home: a multisite study of children with cancer.
MedLine Citation:
PMID:  23629608     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: As home medication use increases, medications previously managed by nurses are now managed by patients and their families. Our objective was to describe the types of errors occurring in the home medication management of children with cancer.
METHODS: In a prospective observational study at 3 pediatric oncology clinics in the northeastern and southeastern United States, patients undergoing chemotherapy and their parents were recruited from November 2007 through April 2011. We reviewed medical records and checked prescription doses. A trained nurse visited the home, reviewed medication bottles, and observed administration. Two physicians independently made judgments regarding whether an error occurred and its severity. Overall rates of errors were weighted to account for clustering within sites.
RESULTS: We reviewed 963 medications and observed 242 medication administrations in the homes of 92 patients. We found 72 medication errors. Four errors led to significant patient injury. An additional 40 errors had potential for injury: 2 were life-threatening, 13 were serious, and 25 were significant. Error rates varied between study sites (40-121 errors per 100 patients); the weighted overall rate was 70.2 errors per 100 patients (95% confidence interval [CI]: 58.9-81.6). The weighted rate of errors with injury was 3.6 (95% CI: 1.7-5.5) per 100 patients and with potential to injure the patient was 36.3 (95% CI: 29.3-43.3) per 100 patients. Nonchemotherapy medications were more often involved in an error than chemotherapy.
CONCLUSIONS: Medication errors were common in this multisite study of outpatient pediatric cancer care. Rates of preventable medication-related injuries in this outpatient population were comparable or higher than those found in studies of hospitalized patients.
Authors:
Kathleen E Walsh; Douglas W Roblin; Saul N Weingart; Kathleen E Houlahan; Barbara Degar; Amy Billett; Christopher Keuker; Colleen Biggins; Justin Li; Karen Wasilewski; Kathleen M Mazor
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2013-04-29
Journal Detail:
Title:  Pediatrics     Volume:  131     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-02     Completed Date:  2013-07-17     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1405-14     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Ambulatory Care
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*,  adverse effects
Cancer Care Facilities
Child
Child, Preschool
Cohort Studies
Community Health Nursing*
Confidence Intervals
Drug Administration Schedule
Female
Home Nursing*
Humans
Incidence
Male
Medication Adherence / statistics & numerical data*
Needs Assessment
Neoplasms / diagnosis,  drug therapy*
Patient Safety
Prospective Studies
Risk Assessment
United States
Grant Support
ID/Acronym/Agency:
U19 CA 79689/CA/NCI NIH HHS
Comments/Corrections
Comment In:
Pediatrics. 2013 May;131(5):e1621-2   [PMID:  23629610 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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