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Pediatricians, Emergency Physicians and Nurses Create Joint Recommendations to Reduce Medication Errors for Children in the Emergency Department

3/1/2018
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Medication errors in hospital settings have the potential to cause serious harm, including death. New joint recommendations for emergency medical care issued today aim to improve pediatric medication safety, reduce errors and save lives.

The American Academy of Pediatrics (AAP), the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) collaborated on the policy statement, “Pediatric Medication Safety in the Emergency Department” published in the March 2018 issue of Pediatrics and the March 2018 edition of Annals of Emergency Medicine.

“Improving pediatric medication safety requires a collaborative approach,” said Lee Benjamin, MD, FAAP, FACEP, lead author of the policy statement. “Many of these mistakes are preventable. With these new recommendations, we hope to save lives and improve health care for children starting before a child goes to the hospital, continuing through emergency care and after a patient is discharged.”

The pediatric emergency care setting can be a high-risk environment for medication errors due to many factors, including lack of standardized drug dosing, weight-based dosing, verbal orders, a hectic environment, lack of clinical pharmacists on the care team and many transitions in care.

“We look forward to collaborating with this diverse group of emergency care professionals to improve medication dose and administration standards, better integrate emergency department technology and enhance training and education across disciplines. These new guidelines take strong steps toward reducing the likelihood of medication errors across acute care settings for children,” said Paul Kivela, MD, MBA, FACEP, president of ACEP. 

The authors note the absence of universally accepted pediatric standards regarding dosing and limits in emergency medical situations. By developing a standard pediatric formulary with specific concentrations and standard dosing, doctors and nurses can benefit from seamless education and practice patterns for prescribing high-risk and frequently used pediatric medications.

“Often, parents don’t or can’t bring their children into pediatric emergency departments. In fact, the vast majority go to emergency rooms departments in community hospitals, which may treat a low number of children,” said ENA president Jeff Solheim, MSN, RN, CEN, TCRN, CFRN, FAEN, FAAN. “These new guidelines are recommended for all emergency departments and will improve care and reduce errors across the spectrum of acute care settings.”

For children returning home, the policy recommends providing metric delivery devices alongside pictograms to aid in medication measurement and decrease errors.

The policy describes 18 recommendations to improve medication safety in the emergency department, including distraction-free safety zones for medication preparation, pharmacists in the emergency department and adding a dedicated pediatric medication safety curriculum to training programs.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds