Medication safety in pediatric care

Medication errors (MEs) are one of the most frequently occurring types of adverse events in hospitalized patients, and 3-10% of MEs result in patient harm. Children are at especially high risk of harm because MEs are potentially more hazardous to them than to adults. With the research presented in this thesis, we aimed to contribute to the knowledge, ultimately to improve medication safety and prevent medication related harm in pediatric patients in hospital.
We performed eight studies (a) to gain knowledge on the prevalence, nature and impact of MEs, and factors that contribute to MEs and (b) to attribute to the existing evidence on interventions to improve medication safety.
We found a high prevalence of MEs and related patient harm. Although the observed harm was considered minor in most cases, it still caused discomfort for the patients. The roads towards improvements is unclear; current evidence on effective interventions to prevent MEs in children is limited. To fill this gap of knowledge, we studied the effect of structured medication review, followed by feedback by a clinical pharmacist as part of the multidisciplinary team in a pediatric intensive care, resulting in a significant reduction of MEs. Frontline healthcare professionals stress the need for interventions on the organizational level, with a focus on interdisciplinary teamwork, redesign of the medication process and safety culture. Comprehensive and sustained medication safety for children can only be achieved in an organization with shared values among all disciplines, and processes with a focus on patient safety.