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    Medication errors in the home: a multisite study of children with cancer

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    Authors
    Walsh, Kathleen E.
    Roblin, Douglas W.
    Weingart, Saul N.
    Houlahan, Kathleen E.
    Degar, Barbara
    Billett, Amy
    Keuker, Christopher P.
    Biggins, Colleen
    Li, Justin W.
    Wasilewski-Masker, Karen
    Mazor, Kathleen M.
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    UMass Chan Affiliations
    Department of Medicine
    Meyers Primary Care Institute
    Department of Pediatrics
    Document Type
    Journal Article
    Publication Date
    2013-05-01
    Keywords
    Medication Errors
    Antineoplastic Agents
    Home Nursing
    Child
    Health Services Research
    Neoplasms
    Oncology
    Pediatrics
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1542/peds.2012-2434
    Abstract
    OBJECTIVE: As home medication use increases, medications previously managed by nurses are now managed by patients and their families. Our objective was to describe the types of errors occurring in the home medication management of children with cancer. METHODS: In a prospective observational study at 3 pediatric oncology clinics in the northeastern and southeastern United States, patients undergoing chemotherapy and their parents were recruited from November 2007 through April 2011. We reviewed medical records and checked prescription doses. A trained nurse visited the home, reviewed medication bottles, and observed administration. Two physicians independently made judgments regarding whether an error occurred and its severity. Overall rates of errors were weighted to account for clustering within sites. RESULTS: We reviewed 963 medications and observed 242 medication administrations in the homes of 92 patients. We found 72 medication errors. Four errors led to significant patient injury. An additional 40 errors had potential for injury: 2 were life-threatening, 13 were serious, and 25 were significant. Error rates varied between study sites (40-121 errors per 100 patients); the weighted overall rate was 70.2 errors per 100 patients (95% confidence interval [CI]: 58.9-81.6). The weighted rate of errors with injury was 3.6 (95% CI: 1.7-5.5) per 100 patients and with potential to injure the patient was 36.3 (95% CI: 29.3-43.3) per 100 patients. Nonchemotherapy medications were more often involved in an error than chemotherapy. CONCLUSIONS: Medication errors were common in this multisite study of outpatient pediatric cancer care. Rates of preventable medication-related injuries in this outpatient population were comparable or higher than those found in studies of hospitalized patients.
    Source

    Pediatrics. 2013 May;131(5):e1405-14. doi: 10.1542/peds.2012-2434. Link to article on publisher's site

    DOI
    10.1542/peds.2012-2434
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37234
    PubMed ID
    23629608
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1542/peds.2012-2434
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