Drug Use and Type of Adverse Drug Events-Identified by a Trigger Tool in Different Units in a Swedish Pediatric Hospital.
adverse drug event
inpatients
patient safety
pediatrics
pharmaceutical preparation
Journal
Drug, healthcare and patient safety
ISSN: 1179-1365
Titre abrégé: Drug Healthc Patient Saf
Pays: New Zealand
ID NLM: 101544775
Informations de publication
Date de publication:
2020
2020
Historique:
received:
26
09
2019
accepted:
13
12
2019
entrez:
27
2
2020
pubmed:
27
2
2020
medline:
27
2
2020
Statut:
epublish
Résumé
The objectives of our study were to determine drug use, type and incidence of all adverse event associated with drug or drug-related processes (Adverse Drug Events, ADE) among pediatric inpatients in relation to hospital unit and length of stay. 600 pediatric (0-18 years) admissions at a Swedish university hospital during one year were included and stratified in blocks to 150 neonatal, surgical/orthopedic, medicine and emergency-medicine unit admissions, respectively. Adverse events were identified from medical records using a pediatric trigger tool. All triggers identifying an adverse event related to drugs and drug-related devices were included. Data on drug use were extracted from the hospital drug-data warehouse. In total, 17794 daily drug orders were administrated to 486 (81.0% exposed) admissions. Parental nutrition, potassium salts and morphine constituted half of all high-risk drugs prescribed. Two-thirds of intravenous irritating drug doses consisted of vancomycin, esomeprazole and meropenem. In 129 (21.5%) admissions, at least one ADE was identified, out of which 21 ADE were classified as more severe (National Coordinating Council Medication Error Reporting Prevention-Index, NCCMERP≥F). The ADE incidence was 47.4 (95% confidence interval: 39.4-57.3) per 1000 admission days and varied by unit category. In neonatal units, 56.9 (49.5-65.4) ADEs/1000 admission days were detected, in surgery/orthopedic 54.2 (40.3-72.8), in medicine 44.1 (33.1-58.7), and in emergency-medicine 14.3 (7.7-26.7) ADEs/1000 admission days were found. The most common types of ADEs were identified by triggers that were not directly aiming at drugs including insufficiently treated pain (incidence peaking already in the first days), skin, tissue or vascular harm (peaking at the end of the first week) and hospital-acquired infections (peaking in later admission days). Adverse drug events are common in pediatric patients. The incidence of ADEs and type of ADE varies by hospital unit and length of hospital stay.
Identifiants
pubmed: 32099481
doi: 10.2147/DHPS.S232604
pii: 232604
pmc: PMC6999776
doi:
Types de publication
Journal Article
Langues
eng
Pagination
31-40Informations de copyright
© 2020 Nydert et al.
Déclaration de conflit d'intérêts
The authors declare that they have no other competing interests in this work.
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