Background: The available knowledge about high-alert medications for children is limited. Because children are particularly vulnerable to medication errors, a list of high-alert medication specifically for children would help to develop effective strategies to prevent patient harm. Therefore, we conducted an international modified Delphi study and validated the results with reports on medication incidents in children based on national data.
Objective: The objective of this study was to generate an internationally accepted list of high-alert medications for a pediatric inpatient population from birth to 18-years old.
Results: The rating panel consisted of 34 experts from 13 countries. In total, 14 medications and 4 medication classes were included with the predefined level of consensus of 75%. The high-alert medications were: amiodarone, digoxin, dopamine, epinephrine, fentanyl, gentamycin, heparine, insulin, morphine, norepinephrine, phenytoin, potassium, propofol and tacrolimus. The high-alert medication classes included in the final list were: chemotherapeutic drugs, immunosuppressive medications, lipid/total parenteral nutrition and opioids.
Conclusion: An international group of experts defined 14 medications and 4 medication classes as high-alert for children. This list might be helpful as a starting point for individual hospitals to develop their own high-alert list tailored to their unique situation.
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http://dx.doi.org/10.1517/14740338.2013.825247 | DOI Listing |
Drugs Real World Outcomes
December 2024
Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Helsinki, Finland.
Background: Paediatric patients are prone to medication errors, but an in-depth understanding of errors involving high-alert medications remains limited.
Objective: We aimed to investigate incident reports involving high-alert medications to describe medication errors, error chains and stages of the medication management and use process where the errors occur in paediatric hospitals.
Methods: A retrospective document analysis of self-reported medication safety incidents in a paediatric university hospital in 2018-20.
Kidney Med
December 2024
Division of Pediatric Nephrology, Dialysis, and Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, IA.
Rationale And Objective: Acute kidney injury (AKI) is a common complication among hospitalized adults, but AKI prediction and prevention among adults has proved challenging. We used machine learning to update the nephrotoxic injury negated by just-in time action (NINJA), a pediatric program that predicts nephrotoxic AKI, to improve accuracy among adults.
Study Design: A retrospective cohort study.
Injury
November 2024
Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563006, PR China; Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, Guizhou, PR China; Center for Pediatric Trauma Research & Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. Electronic address:
Objective: To investigate the prevalence and influencing factors of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in trauma patients, and to explore the predictive effect of ASD on PTSD.
Methods: A prospective study was conducted on patients hospitalized due to injuries. The first survey used the ASD scale to assess the occurrence of ASD.
J Clin Med
October 2024
Hospital Pharmacy, RWTH Aachen University Hospital, 52074 Aachen, Germany.
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