Hospital medication errors frequent with children

Hospitals frequently make medication errors with child patients due to the heavy workload of nurses, distraction and poor communication, a new Canadian study suggests.

Nursing workload, ineffective communication factors in 4 child deaths

Hospitals frequently make medication errors with child patients due to the heavy workload of nurses, distraction and poor communication, a new Canadian study suggests.

Serious errors when administering drugs to children are the most common medical error involving children, according to previous research. Drugs approved for adults are often used for children under the age of 12, although they aren't formulated for pediatric use.

The delivery of a single medication involves up to 40 steps with room for error, previous research suggests. ((CBC))

When Kim Sears, an assistant professor of nursing at Queen's University in Kingston, Ont., and her colleagues anonymously surveyed nurses at hospitals affiliated with universities across the country, nurses said four young patients died because of some medication errors during the three-month study.

In total, 372 errors were reported, including 245 errors and 127 instances where an error was caught before the drug was administered.

The errors included giving children medication at the wrong the time, the wrong dose or the incorrect drug.

Administering medications to children involves basing the dose on the child's weight.

"Different places use different kinds of math calculations, but there needs to be a standardized approach used," Sears said.

Her other recommendations were that "the areas that nurses are giving the medications are well lit and clutter free and nurses aren't distracted while they're preparing the medications."

Nurses may prepare medications from a cart or in a chaotic area of the unit where housekeeping interrupts to mop the floor and where other health-care professionals, patients and visitors are often asking questions, Sears said.

"Pediatric medication administration errors are occurring frequently and are ultimately devastating to children and their families," the study's authors concluded in the January issue of the Journal of Pediatric Nursing.

To make the administration of medications safer, the researchers' recommendations included:

  • Increasing training for future pediatric nurses
  • Improving communication between doctors, nurses and pharmacists including during training.
  • Standardizing medication delivery, such as stocking drugs that are dangerous to children away from common drugs. 

Sears called it the first study she knows of in Canada to ask nurses to record errors and near misses when they occur.

She encouraged hospitals to share their experiences and best practices with front-line staff and with each other.

The study was funded by a nursing research fellowship at the University of Toronto.

With files from CBC's Amina Zafar