Anästh Intensivmed 2019;60:164-172 Deutsch English
Original Articles - Emergency Medicine
The influence of education and experience on paediatric emergency drug dosing errors – an interventional questionnaire study using a tabular aid

Authors

Jost Kaufmann, Kinderkrankenhaus der Kliniken der Stadt Köln gGmbH, Amsterdamer Straße 59, 50735 Köln, Deutschland
T. Engelhardt,
I. Steinwegs,
J. Hinkelbein,
F. Piekarski,
M. Laschat,
A. Böhmer,
M. Hellmich,
F. Wappler,

Keywords

Patient Safety, Medication Errors, Paediatrics, Emergencies

Summary

Background: Several interventions including reading drug doses from a table are known to reduce drug dosing errors in paediatric emergencies. The role of education and experience of the opera­tor on the occurrence of these errors with or without supporting aids is unknown. Methods: Within an interventional questionnaire trial, medical professionals were first asked to indicate their training (nurse (N), medical student (MS), trainee (T) or consultant physician (CP)). They were then requested to calculate the dose of four emergency drugs within 2 minutes time for a child weighing 7 kg, first unaided and then with a tabular aid. Deviations from the recommended dose of 120% (DRD120), 300% (DRD300) and 1000% (DRD1000) with or without the tabular aid were measured. Results: A total of 186 questionnaires and 1,326 drug prescriptions were available. CP made less unaided emer­gency drug dosing errors e.g. with epinephrine when compared to T, N and MS (DRD120: CP 18%, T 23%, N 50% and MS 78%, respectively). With the tabular aid, fewer errors were made (DRD120: CP 7% (p=0.031), T 9% (p=0.375), N 11% (p=0.016), MS 0% (p<0.001)). The tabular aid greatly reduced errors in N and MS, eliminating DRD1000 in N and all DRDs in MS. Despite the tabular aid, CP and T conti- nued to make potentially life-threatening errors when prescribing epinephrine. Conclusions: Although CP and T made fewer unaided emergency drug dosing errors, they failed to gain comparable benefits from a tabular aid. Strict adherence to safety structures and implementation of a safety culture is required to further reduce paediatric emergency drug prescription errors.
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