Healthcare News & Insights

Avoid medication errors in your pediatric patients

Did you know medication errors are the most common and preventable cause of harm to your pediatric patients? 

The reasons being that medication doses are weight-based in pediatrics — specific to each patient — and the recommended doses are given in kilograms allowing for simple calculation errors. Most adult medications have a standard dosing unit.

A 2009 study of 479 medication errors involving the wrong weights discovered that over 25% were due to confusion between pounds and kilograms. (A kilogram equals approximately 2.2 pounds.)

In addition, 18% of serious preventable medication errors are the result of not having essential information at the time of prescribing, dispensing and administering medications.

One place where high medical error rates with serious consequences are known to occur is in the emergency room (ER). If an incorrect weight is recorded in the ER, it could very easily be passed on to the inpatient units and wrong medication doses could be perpetuated.

Recommended practices

To keep pediatric patients safe from medication errors, the Emergency Nurses Association (ENA) issued a position statement.  The association recommends that:

  1. Pediatric weights only be measured and documented in kilograms
  2. Scales used to weigh pediatric patients only be configured to record weights in kilograms
  3. Pediatric weights are recorded in a prominent place on the medical record
  4. Electronic medical records are standardized to allow only kilograms for pediatric weight entries
  5. The pediatric patient’s actual weight is considered part of the mandatory nursing assessment unless they require resuscitation or emergent stabilization
  6. For the pediatric patient who requires resuscitation or emergent stabilization, a standard method of estimating weight in kilograms is used (i.e., length-based system), and
  7. The pediatric patient’s weight in kilograms is included in any inter- or intra-disciplinary patient hand-off report.

The American College of Emergency Physicians, the American Academy of Pediatrics and the Institute for Safe Medicine Practices have all endorsed the ENA’s position statement.

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