Liquid Medication Errors and Dosing Tools: A Randomized Controlled Experiment.

Autor:	Yin HS; Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, New York; yinh02@med.nyu.edu.; Department of Population Health, NYU School of Medicine, New York, New York., Parker RM; Department of Medicine., Sanders LM; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California., Dreyer BP; Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, New York., Mendelsohn AL; Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, New York., Bailey S; Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina., Patel DA; Division of General Internal Medicine and Geriatrics, and., Jimenez JJ; Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, New York., Kim KA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Jacobson K; Rollins School of Public Health, and., Hedlund L; Division of General Internal Medicine and Geriatrics, and., Smith MC; Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California., Maness Harris L; Department of Pediatrics, NYU School of Medicine-Bellevue Hospital, New York, New York., McFadden T; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia., Wolf MS; Division of General Internal Medicine and Geriatrics, and.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2016 Oct; Vol. 138 (4). Date of Electronic Publication: 2016 Sep 12.
DOI:	10.1542/peds.2016-0357
Abstrakt:	Background and Objectives: Poorly designed labels and packaging are key contributors to medication errors. To identify attributes of labels and dosing tools that could be improved, we examined the extent to which dosing error rates are affected by tool characteristics (ie, type, marking complexity) and discordance between units of measurement on labels and dosing tools; along with differences by health literacy and language. Methods: Randomized controlled experiment in 3 urban pediatric clinics. English- or Spanish-speaking parents (n = 2110) of children ≤8 years old were randomly assigned to 1 of 5 study arms and given labels and dosing tools that varied in unit pairings. Each parent measured 9 doses of medication (3 amounts [2.5, 5, and 7.5 mL] and 3 tools [1 cup, 2 syringes (0.2- and 0.5-mL increments)]), in random order. Outcome assessed was dosing error (>20% deviation; large error defined as > 2 times the dose). Results: A total of 84.4% of parents made ≥1 dosing error (21.0% ≥1 large error). More errors were seen with cups than syringes (adjusted odds ratio = 4.6; 95% confidence interval, 4.2-5.1) across health literacy and language groups (P < .001 for interactions), especially for smaller doses. No differences in error rates were seen between the 2 syringe types. Use of a teaspoon-only label (with a milliliter and teaspoon tool) was associated with more errors than when milliliter-only labels and tools were used (adjusted odds ratio = 1.2; 95% confidence interval, 1.01-1.4). Conclusions: Recommending oral syringes over cups, particularly for smaller doses, should be part of a comprehensive pediatric labeling and dosing strategy to reduce medication errors. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2016 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
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