Specific strategies discussed by the panel, as well as recent advances in improving pediatric medication safety, are described. Decreasing Pediatric Medication Prescribing Errors in the ED Computerized Physician Order Entry Historically, the majority of pediatric medication errors were associated with the ordering phase of the medication process.
Specific risks related to pediatric weight-based dosing include not using the appropriate weight, 6 performing medication calculations based on pounds instead of the recognized personal statement pediatric critical care of kilograms, 6 and making inappropriate calculations, including tenfold dosing errors.
In addition to the lack of science to guide medication dosing in patients with obesity, 21 frequent underdosing 22 is reported, and currently available resuscitation tools are commonly imprecise. However, CPOE systems have not fully eliminated medication errors. Commercial or independently developed CPOE systems may fail to address critical unique pediatric dosing requirements. In addition, providers may override CDS, despite its proven success in reducing errors.
The development of an override algorithm can help reduce user variability. The development of a standard pediatric formulary, independent of an adult-focused system, can reduce opportunities for error by specifying limited concentrations and standard dosage of high-risk and frequently used medications, such as resuscitation medications, vasoactive infusions, narcotics, and antibiotics, as well as look-alike and sound-alike help with assignment At least 1 large hospital organization has successfully implemented this type of change.
Pharmacist-managed reconciliation has had a positive impact for admitted pediatric patients and may translate to the emergency setting. A standard curriculum may include content such as common medication errors in children, systems-improvement tools to avoid or abate errors, and the effects of developmental differences in pediatric patients.
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