Background and aims Children are considered to be at high risk of experiencing harm due to medication erros (MEs). Hospitals implement various interventions to reduce MEs, but their effectiveness is unclear. Therefore, we performed a systematic review to identify evidence-based interventions to reduce MEs in hospitalised children.
Methods We searched the following databases: CINAHL, CENTRAL, Dissertations and Theses Database, EMBASE, EPOC Group Specialised Register, MEDLINE, Nursing and Allied Health, PsycINFO, Web of Science, Cochrane Database of Systematic Reviews and DARE. Furthermore, we searched the grey literature, trial registries and the reference lists of all included studies.
We included randomised controlled trials, controlled before-after studies and interrupted time series. The outcome measures included MEs, (potential) patient harm, resource utilisation and unintended consequences of the interventions. Two reviewers independently selected studies and assessed the studies quality.
Results Seven studies were included describing five different interventions: clinical pharmacist (two studies), computerised physician order entry (two studies), barcode medication administration, a structured prescribing form, and a check and control checklist in combination with feedback. Most studies resulted in a reduction in MEs, but the benefits for the patients in terms of less harm were not conclusive. Clinical and methodological heterogeneity between the studies precluded meta-analyses.
Conclusion The current evidence on effective interventions to prevent MEs in a paediatric population in hospital is limited. There is a need for comparative studies with robust study designs that investigate interventions including components that focus on specific paediatric safety issues.