Reducing Pediatric Drug Errors in Rural EDs

Reducing Pediatric Drug Errors in Rural EDs

Previous research has shown that patients receiving treatment in EDs are at particularly high risk for experiencing medication errors because of the acute nature of presenting illnesses, the chaotic environment, and the lack of oversight to verify medication orders and administration, among other reasons. For children, the risk of medication errors is heightened because weight-based drug dosing practices are common in this patient population. In addition, many healthcare providers have limited experience with pediatric prescribing and pharmacotherapy. Several studies have suggested that physician prescribing is the most common source of medication errors among children and in EDs. Physicians practicing in rural areas face distinct disadvantages when caring for seriously ill or injured pediatric patients. “Several factors can contribute to the increased risk of medication errors in children receiving care in rural EDs,” explains James P. Marcin, MD, MPH. “These may include issues relating to physician experience and specialized training as well as infrastructural factors.” The Role of Telemedicine To address shortcomings, telemedicine is increasingly being used as an alternative to telephone consultations for providing pediatric specialty consultations to children presenting to rural and underserved EDs throughout the United States. “Telemedicine has the potential to prevent medication errors that result from the lack of access to experienced staff and pediatric specialty expertise,” says Dr. Marcin. “Research has shown that having specialists treat children can lower risks of medication errors.” He notes, however, that although telemedicine has been proposed as a potential solution, few data support its clinical effectiveness and its effect on medication errors. A Closer Look In a study published in Pediatrics, Dr. Marcin and colleagues evaluated whether pediatric...

Conference Highlights: ACC.12

New research was recently presented at ACC.12, the annual scientific meeting of the American College of Cardiology, from March 24-27 in Chicago. The features below highlight just some of the studies that emerged from the meeting. Angioplasty Safe at Community Hospitals Should LDL Be Targeted Early in Life? Improving BP Control With Telemedicine A Checklist to Reduce HF Readmissions Visualization Encourages Statin Adherence & Lifestyle Changes Improving the Quality of ACS Care Angioplasty Safe at Community Hospitals The Particulars: Community hospitals without cardiac surgery units have traditionally performed angioplasties only in emergency situations. Patients needing elective angioplasty have typically been transferred to hospitals with on-site cardiac surgery units. A recent guideline from the American College of Cardiology and American Heart Association questioned the need for such transfers. Data Breakdown: In a study, nearly 19,000 patients were randomized to undergo elective angioplasty at a facility with on-site cardiac surgery or at one of 60 community hospitals that had undergone special preparations to perform angioplasty. No differences were observed in death rates between the two facility types. Furthermore, no significant differences were seen in rates of complications, such as bleeding, renal failure, and stroke. Take Home Pearl: With appropriate preparation, community hospitals without on-site cardiac surgery units appear to have the capability to safely and effectively perform elective angioplasty. Should LDL Be Targeted Early in Life? The Particulars: Patients with high LDL cholesterol often do not begin treatment to lower their LDL levels until after coronary heart disease (CHD) has been quietly developing for years. Coronary atherosclerosis begins early in life. It has been hypothesized that lowering LDL at a younger...