241 - Measurement of Ambulatory Medication Errors in Children

Children use most medications in the ambulatory setting where errors are infrequently intercepted. There is currently no established set of measures of outpatient pediatric medication errors.

Objective: To identify the range of existing measures of outpatient pediatric medication errors, including errors at home.

Design/Methods:

We performed a scoping review of the published literature using PubMed, CINAHL, PyscINFO, Web of Science, Embase, and Cochrane and searched grey literature from clinical trials, grant funding agencies, webpage searches, and grey literature search engines. Studies were included if they measured ambulatory, including home, medication errors in children, aged 0-26 years. Data were grouped by phase of the medication use pathway and thematically by measure type.

Results: We included 137 published studies from 1989-2020 and 8 studies from the grey literature and identified 132 measures of medication errors. Most studies addressed errors in medication prescribing (35%) and administration at home (26%). There were no studies that included measures of medication monitoring errors. Assessments of medication-associated harm (24%), dosing errors (15%), and errors in liquid medication administration (12%) were frequently reported measures. In the grey literature 4 studies are investigating technology-based applications to measure and reduce ambulatory medication errors, which include actively engaging parents and caregivers in error surveillance and reporting.

Conclusion(s):

Comprehensive assessments of ambulatory medication use that include direct observation are highly reliable, though resource intensive, methodologies for error detection. Currently available and operationalized measures are limited in their utility for application at the health system level to improve medication error quality and safety.