The proportion of errors in medical prescriptions and their executions among hospitalized children before and during accreditation

Abstract

Objective: To evaluate the rate of medication related errors in the pediatric ward and pediatric emergency department (PED), before and after implementing intervention strategies according to the Joint Commission International (JCI) accreditation program.

Design: A retrospective cross-sectional study that included chart review.

Setting: A university affiliated pediatric ward and PED.

Participants: Children 0-18 years old admitted on February 2013 (before the JCI program) and February 2014 (during implementation of the JCI program).

Intervention(s): A training program designed to meet the JCI official standards on medication prescribing.

Main outcome measure(s): The number of prescribing and medication administration errors in the 2 years.

Results: We collected 937 valid prescription orders and 924 administration orders (1861 medical orders) from February 2013, and 961 valid prescription orders and 958 administration orders (1919 medical orders) from February 2014. There was a significant reduction in prescribing errors from 6.5 to 4.2% between years 2013 and 2014 (P = 0.03). There was no significant difference in administration error rates between the two periods (104 (11.3%) in the first period and 114 (11.9%) in the second; P = 0.61).

Conclusions: The errors rate we found was within the range described in the literature. Quality assurance interventions can significantly reduce medication prescribing errors.

Keywords: accreditation; hospital medicine; medication errors; patient safety; pediatrics.