Children in hospitals are particularly vulnerable to medication errors, mainly because of outdated methods for administering drugs, according to a seminal study by the Boston Children’s Hospital.
The seminal study, published in the Journal of the American Medical Association, examined 10,778 medication orders made in the pediatric wards of two hospitals where doctors treated a diverse socioeconomic mix of patients.
The study found that compared to previous studies in adult settings, medication errors were more common in pediatric settings. Of the 616 errors found, 79 percent of them occurred during drug ordering or involved incorrect dosing and intravenous medication. Medication errors by an anesthesiologist or other doctor or nurse are generally preventable errors and may be grounds for a medical malpractice claim.
Not surprisingly, the study found that children were more vulnerable than adults to errors because their dosage calculations were significantly more complex. Children often require dosages based on their weight that must be diluted from stock medication. Each additional step opens the door to risk. Children are also physically less capable of tolerating medication errors. Typically, they don’t question medications.
In fact, error rates in the study were highest for those most sensitive to medication and least able to communicate, such as infant patients in the neonatal intensive care unit.
To prevent medication errors, the study recommends standardizing communication in one of two ways, both of which provide safety checks and balances: computerization of orders and the presence of a full-time pharmacist dedicated to the ward.
Today, many prescriptions are entered electronically to prevent transcription errors that can occur if a doctor’s handwriting is illegible. One study found that errors were reduced 55 percent for adults in another hospital with a computerized drug order system.
A full-time pharmacist dedicated to pediatric patients offers a safety net similar to a computerized system. They can help inform other hospital staff about potential problems before medication requests are made. They can also not only monitor drug fulfillment closely, but dispensing and storage as well. Another study found that having a dedicated pharmacist in an adult setting reduced errors 66 percent.
Researchers at Boston’s Children Hospital noted that identifying problems with drug ordering requires both cooperation from staff and the political will to make changes. An atmosphere of suspicion makes it difficult for staff to acknowledge the existence of a problem. Such cultural problems continue in many hospitals.
Older patients and the parents of younger patients – especially infants incapable of protecting themselves – should be aware of these situations and understand they can seek representation with a law firm specializing in medical malpractice cases if preventable hospital errors lead to an adverse drug reaction.
Families harmed by medication errors in a hospital setting should understand their legal options by talking with a medical malpractice attorney.