Tobacco Control, Inpatient Medication Discrepancies, Child Care Health and SafetyPrevalence and Clinical Significance of Medication Discrepancies at Pediatric Hospital Admission
Section snippets
Setting
This is a prevalence study on a consecutive sample of general pediatric admissions that uses methodology described by Cornish and colleagues.4 The setting was a 60-bed general pediatrics unit within a 300-bed tertiary-care children's hospital in Toronto, Canada. Approximately 90% of admissions to the unit come from the emergency department. The unit is staffed by a combination of traditional teaching teams consisting of students, residents, and faculty as well as hospitalist-only teams, with
Results
During the study period, 356 admissions were identified by the study pharmacist (Figure). Forty (11%) were not approached, either as a result of lack of availability of the study pharmacist within 24 hours (n = 21) or due to patient factors (n = 19), the most common of which was lack of an available parent/guardian despite repeated attempts to make contact in person and by phone (n = 12). Thus, of the 356 admissions, 316 patients (89%) were approached. Of these, 21 were excluded (discharged within 24
Discussion
Our findings demonstrate that medication errors at admission are common in this general pediatric population, and the sample was large enough to detect highly significant differences in discrepancy rates. The high degree of agreement among the physicians supports this method as a valid measure of the clinical importance of unintentional discrepancies. In contrast to previous studies of similar methodology, the severity ratings were performed by authors unaffiliated with the study, who are
Acknowledgments
This study was funded by Paediatric Consultants, The Hospital for Sick Children, Toronto, Ontario, Canada (principal investigator, Maitreya Coffey). We thank Dr Gideon Koren for his review of the manuscript and Christina Stevancec for assistance with manuscript preparation.
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