Improving medication safety in the ED: 18 recommendations reflect joint effort

The American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association have come up with 18 recommendations for improving pediatric medication safety in the emergency department (ED), to be published in the March issue of <i>Pediatrics</i>.

The American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association have come up with 18 recommendations for improving pediatric medication safety in the emergency department (ED), to be published in the March issue of <i>Pediatrics</i>. Opportunities to improve medication safety typically fall into three areas: prescribing errors, ED administration errors, and home administration errors. Within the ED, computerized physician order entry has significantly reduced prescribing errors, specifically those related to dose calculation, but there is room for improvement. Recommendations include measuring and recording weight in kilograms only, which will remove the common error of calculating medication dosage based on pounds. Providers are also advised to develop a standard pediatric formulary with specific concentrations and standard dosing. In addition, implementing and supporting the availability of ED pharmacists, utilizing a two-provider check for high-alert medications, and promoting use of distraction-free zones for medication preparation will encourage safe medication administration. For medication administration in the home, providing standardized delivery devices as well as pictogram-based dosing instruction sheets decreases error rates, as does milliliter-only dosing for liquid medication.