Walsh et al studied medication errors affected pediatric patients being cared for at home. The authors are from University of Massachusetts, Meyers Primary Care Institute (Worchester), Kaiser Permanente Georgia, Dana-Farber Cancer Institute, Children's Hospital Boston and Emory University.

Patient selection: pediatric patient at home


Types of error involving family members:

(1) wrong dose

(2) wrong dosing frequency

(3) missed doses

(4) expired medications

(5) wrong administration technique


Types of error involving healthcare providers:

(1) labeling error

(2) prescription error


Risk factors for medication errors or for a significant error:

(1) frequent dosing changes, especially if not reflected in medication label or instructions

(2) insufficient caregiver education

(3) miscommunication or misunderstood communication

(4) high risk medications (chemotherapy, other)

(5) polypharmacy


An error may go undetected in many cases. Detection may increase if there is a home visit nurse who reviews medications or if there is aggressive follow-up in the office.


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