The effects of resident level of training on the rate of pediatric prescription errors in an academic emergency department

Garrett S. Pacheco, Chad D Viscusi, Daniel P. Hays, Dale P Woolridge

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Medication errors are a leading cause of increased cost and iatrogenic injury in the pediatric population. In the academic setting, studies have suggested that these increased error rates are related primarily to resident inexperience, thus advocating a higher level of supervision. Study Objective: We sought to identify the number of prescription errors in our institution's academic Emergency Department, how this varied between the beginning and end of the academic year and between practitioners at varying levels of training. Methods: A retrospective review of computer-based outpatient prescriptions for children aged 0-12 years old was performed. Outpatient prescriptions were reviewed during a 2-week time block at the end of the academic year and beginning of the academic year (109 [June] and 111 [July] data sets, respectively). Prescriptions were retrieved electronically and reviewed for appropriate dosing. Errors were defined as those that varied > 10% above or below recommended weight-based dosing. Results: Twenty-nine (16.1%) of 180 written prescription orders were determined to be incorrectly written. Error rates were not significantly different between the beginning and end of the academic year. In both sampling periods, a higher percentage were found to be derived from senior level practitioners in both data sets (9/14 and 10/15; respectively), but few of these were considered high-grade prescription errors. Conclusions: Overall prescription error rates at our institution are comparable to nationally reported error rates in children. Error rates were not associated with newly matriculated residents. These findings dispute previously held opinion that physician level of training is a factor of prescription errors.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
Volume43
Issue number5
DOIs
StatePublished - Nov 2012

Fingerprint

Prescriptions
Hospital Emergency Service
Pediatrics
Outpatients
Medication Errors
Dissent and Disputes
Physicians
Weights and Measures
Costs and Cost Analysis
Wounds and Injuries
Population

Keywords

  • academic emergency department
  • pediatrics
  • prescription errors
  • residency training

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

@article{beabd27809c14c58b27270ebdb930739,
title = "The effects of resident level of training on the rate of pediatric prescription errors in an academic emergency department",
abstract = "Background: Medication errors are a leading cause of increased cost and iatrogenic injury in the pediatric population. In the academic setting, studies have suggested that these increased error rates are related primarily to resident inexperience, thus advocating a higher level of supervision. Study Objective: We sought to identify the number of prescription errors in our institution's academic Emergency Department, how this varied between the beginning and end of the academic year and between practitioners at varying levels of training. Methods: A retrospective review of computer-based outpatient prescriptions for children aged 0-12 years old was performed. Outpatient prescriptions were reviewed during a 2-week time block at the end of the academic year and beginning of the academic year (109 [June] and 111 [July] data sets, respectively). Prescriptions were retrieved electronically and reviewed for appropriate dosing. Errors were defined as those that varied > 10{\%} above or below recommended weight-based dosing. Results: Twenty-nine (16.1{\%}) of 180 written prescription orders were determined to be incorrectly written. Error rates were not significantly different between the beginning and end of the academic year. In both sampling periods, a higher percentage were found to be derived from senior level practitioners in both data sets (9/14 and 10/15; respectively), but few of these were considered high-grade prescription errors. Conclusions: Overall prescription error rates at our institution are comparable to nationally reported error rates in children. Error rates were not associated with newly matriculated residents. These findings dispute previously held opinion that physician level of training is a factor of prescription errors.",
keywords = "academic emergency department, pediatrics, prescription errors, residency training",
author = "Pacheco, {Garrett S.} and Viscusi, {Chad D} and Hays, {Daniel P.} and Woolridge, {Dale P}",
year = "2012",
month = "11",
doi = "10.1016/j.jemermed.2012.01.016",
language = "English (US)",
volume = "43",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - The effects of resident level of training on the rate of pediatric prescription errors in an academic emergency department

AU - Pacheco, Garrett S.

AU - Viscusi, Chad D

AU - Hays, Daniel P.

AU - Woolridge, Dale P

PY - 2012/11

Y1 - 2012/11

N2 - Background: Medication errors are a leading cause of increased cost and iatrogenic injury in the pediatric population. In the academic setting, studies have suggested that these increased error rates are related primarily to resident inexperience, thus advocating a higher level of supervision. Study Objective: We sought to identify the number of prescription errors in our institution's academic Emergency Department, how this varied between the beginning and end of the academic year and between practitioners at varying levels of training. Methods: A retrospective review of computer-based outpatient prescriptions for children aged 0-12 years old was performed. Outpatient prescriptions were reviewed during a 2-week time block at the end of the academic year and beginning of the academic year (109 [June] and 111 [July] data sets, respectively). Prescriptions were retrieved electronically and reviewed for appropriate dosing. Errors were defined as those that varied > 10% above or below recommended weight-based dosing. Results: Twenty-nine (16.1%) of 180 written prescription orders were determined to be incorrectly written. Error rates were not significantly different between the beginning and end of the academic year. In both sampling periods, a higher percentage were found to be derived from senior level practitioners in both data sets (9/14 and 10/15; respectively), but few of these were considered high-grade prescription errors. Conclusions: Overall prescription error rates at our institution are comparable to nationally reported error rates in children. Error rates were not associated with newly matriculated residents. These findings dispute previously held opinion that physician level of training is a factor of prescription errors.

AB - Background: Medication errors are a leading cause of increased cost and iatrogenic injury in the pediatric population. In the academic setting, studies have suggested that these increased error rates are related primarily to resident inexperience, thus advocating a higher level of supervision. Study Objective: We sought to identify the number of prescription errors in our institution's academic Emergency Department, how this varied between the beginning and end of the academic year and between practitioners at varying levels of training. Methods: A retrospective review of computer-based outpatient prescriptions for children aged 0-12 years old was performed. Outpatient prescriptions were reviewed during a 2-week time block at the end of the academic year and beginning of the academic year (109 [June] and 111 [July] data sets, respectively). Prescriptions were retrieved electronically and reviewed for appropriate dosing. Errors were defined as those that varied > 10% above or below recommended weight-based dosing. Results: Twenty-nine (16.1%) of 180 written prescription orders were determined to be incorrectly written. Error rates were not significantly different between the beginning and end of the academic year. In both sampling periods, a higher percentage were found to be derived from senior level practitioners in both data sets (9/14 and 10/15; respectively), but few of these were considered high-grade prescription errors. Conclusions: Overall prescription error rates at our institution are comparable to nationally reported error rates in children. Error rates were not associated with newly matriculated residents. These findings dispute previously held opinion that physician level of training is a factor of prescription errors.

KW - academic emergency department

KW - pediatrics

KW - prescription errors

KW - residency training

UR - http://www.scopus.com/inward/record.url?scp=84869085097&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869085097&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2012.01.016

DO - 10.1016/j.jemermed.2012.01.016

M3 - Article

C2 - 22464610

AN - SCOPUS:84869085097

VL - 43

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

IS - 5

ER -