To: J_F_Shepard who wrote (504978 ) 8/14/2009 9:53:01 PM From: longnshort Read Replies (1) | Respond to of 1578133 Medical error has received a great deal of attention in recent years. The phrase "medical error" is an umbrella term given to all errors that occur within the healthcare system including mishandled surgery, diagnostic errors, equipment failures, and medication errors (MEs). Medical error is a large problem in the UK and the US, in both primary and secondary care, and policy initiatives have been implemented to reduce it.[1-5] MEs are probably one of the most common types of medical error. In the US, it has been estimated that MEs kill 7000 patients a year.[1] In UK hospitals, the incidence and consequences of MEs seem similar to those reported in the US: prescribing errors occur in 1.5% of prescriptions, and administration errors occur in 3-8% of nonintravenous doses given.[6,7] Much of the research into MEs and their prevention has been performed in facilities that care primarily for adults. Information on the incidence of MEs in pediatrics is scarce. Pediatrics poses a unique set of risks, predominantly because of wide variation in body mass, which requires doses to be calculated individually based on patient age, weight or body surface area, and clinical condition. This increases the likelihood of errors, particularly dosing errors.[8] In addition, dosage formulations are often extemporaneously compounded to meet the need for small doses in these patients, and there is a lack of information on pediatric doses and indications.[9] In a one week study of over 10 000 UK hospital beds, it was shown that the number of pharmacist interventions (most of which relate to prescribing errors) was higher in pediatric wards than in geriatric, medical, or surgical wards.[10] In addition, there is recent evidence from the US that potentially harmful MEs may be 3 times more common in the pediatric population than in adults.[11] This suggests that the epidemiologic characteristics of MEs may be different between adults and children. The situation in the UK is not clear. It has been estimated that 1675 avoidable MEs occur each year in UK pediatric inpatients.[12] However, this figure is based on spontaneous reporting of MEs and is therefore likely to be a gross underestimate due to underreporting. Our objectives were to review studies of the incidence of MEs in pediatric patients and to identify common types of error in this patient group. The literature on MEs needs to be evaluated carefully, as there are several methodological issues that can markedly affect the interpretation of findings.[8] These issues, summarized by Wong et al.,[8] include the definition of ME used, the method by which MEs are detected, and the setting studied.