Developing a process to measure actual harm from medication errors in paediatric inpatients: from design to implementation.
Measuring the incidence and severity of potential or actual harm is an ongoing challenge in patient safety. In this study at one pediatric hospital, researchers evaluated a new systematic approach using multidisciplinary review to assess actual harm from inpatient medication errors. Among 566 cases identified via medical record review and direct observation of medication administration, the multidisciplinary panel identified actual harm in 89 cases, with three-quarters of actual harm occurring in medication administration cases.