Administering opioids to children is a delicate task. Too often, mistakes can be made.
An interesting Canadian study has revealed the vast majority of never events in opioid administration to children were avoidable. Many American studies of a similar nature have arrived at the same conclusions. Root causes tended to fall into one or more of four categories: communication, policies/procedures, training and equipment/environment.
The most common reasons for opioid medication errors were: a lack of clear guidelines either for the infusion adjustment rate or for weaning the patient off the medication; no standard opioid concentrations; no existing policies in place to follow for administering opioids; and no guidelines on properly monitoring and charting pain levels, level of consciousness and/or vital signs.
There were other factors involved, such as medical personnel’s level of fatigue and the number of patient transfers between units. Although the focus of the study was to fix what could be fixed to address patient needs, staff fatigue and patient transfers were mentioned as a concern, albeit one that could not necessarily be fixed, or changed.
The study itself was not one to just identify problems areas without also proposing solutions. In their report, researchers suggested several ways to improve patient safety, hospital-wide. They included implementing system wide monitoring, proper documentation, a reduction in paperwork errors and putting clear policies in place dealing with opioid administration, weaning and conversion in paediatric transfer cases to various locations, promoting further education in how to handle acute pain management for children, and understanding how opioids interacted with other drugs and ensuring proper acute pain management care.
This is not the only study on the potentially error-riddled task of administering pain medications to children. Another Canadian study, released in 2012 in Pediatrics (2012;129:916-924) focused on an alarming trend in medication errors affecting children. The most common causes pinpointed for mistakes in that study included patient transfers, programming more than one infusion at a time, being distracted while setting up an infusion and not programming the infusion equipment properly.
A hospital is a busy place to begin with and adding in overworked, overwhelmed staff simply increases the likelihood of a medication error, whether it is for a child or for an adult. Medical malpractice comes in many forms, and medication errors are higher on the list than many people realize. If you have been the victim of a medication error, or your child has been given the wrong medication, the wrong dose at the wrong time, a double dose or did not receive opioids when they needed them, speak to an experienced Cleveland medical malpractice lawyer. When mistakes are made, someone must be held accountable for them.
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