Impact of pharmacist interventions on medication errors in hospitalized pediatric patients: a systematic review and meta
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REVIEW ARTICLE
Impact of pharmacist interventions on medication errors in hospitalized pediatric patients: a systematic review and meta‑analysis Lina Mohammad Naseralallah1 · Tarteel Ali Hussain1 · Myriam Jaam2 · Shane Ashley Pawluk3,4 Received: 24 February 2020 / Accepted: 10 April 2020 © Springer Nature Switzerland AG 2020
Abstract Background Medication errors are avoidable events that may occur at any stage of the medication use process. Implementing a clinical pharmacist is one strategy that is believed to reduce the number of medication errors. Pediatric patients, who are more vulnerable to medication errors due to several contributing factors, may benefit from the interventions of a pharmacist. Aim of the review To qualitatively and quantitatively evaluate the impact of clinical pharmacist interventions on medication error rates for hospitalized pediatric patients. Methods PubMed, EMBASE, Cochrane Controlled Trials Register and Google Scholar search engines were searched from database inception to February 2020. Study selection, data extraction and quality assessment was conducted by two independent reviewers. Observational and interventional studies were included. Data extraction was done manually and the Crowe Critical Appraisal Tool was used to critically appraise eligible articles. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Results 19 studies were systematically reviewed and 6 studies (29,291 patients) were included in the meta-analysis. Pharmacist interventions involved delivering educational sessions, reviewing prescriptions, attending rounds and implementing a unit-based clinical pharmacist. The systematic review indicated that the most common trigger for pharmacist interventions was inappropriate dosing. Pharmacist involvement was associated with significant reductions in the overall rate of medication errors occurrence (OR 0.27; 95% CI 0.15 to 0.49). Conclusion Pharmacist interventions are effective for reducing medication error rates in hospitalized pediatric patients. Keywords Clinical pharmacist · Medication error · Pediatrics · Litterature Review
Impacts on practice • A clinical pharmacist caring for pediatric patients can
reduce the rates of medication errors.
* Shane Ashley Pawluk [email protected] 1
College of Pharmacy, QU Health, Qatar University, Doha, Qatar
2
Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
3
Department of Pharmacy, Clinical Pharmacy, Children’s & Women’s Health Centre of British Columbia, Vancouver, BC, Canada
4
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
• Direct pharmacist involvement in education, direct
patient care, therapeutic drug monitoring, drug distribution oversight and quality improvement have been demonstrated to reduce the rates of medication errors in pediatric patients. • Dosing errors are the most common medication errors occurring
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