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PSNet: Patient Safety Network
Journal Article

The role of advice in medication administration errors in the pediatric ambulatory setting.

Lemer C, Bates DW, Yoon C, et al. Journal of patient safety. 2009;5:168-75.

The majority of adverse drug events in children can be ascribed to incorrect medication administration by parents. Education around medications by physicians or pharmacists would seem to be an effective way of preventing such errors, but this study found that parents received such advice in only a minority of cases. Parents who received medication education were not statistically less likely to commit a medication administration error. The authors interpret this finding as an indication that medication counseling was likely of poor quality even when it was given. A case of an inadvertent medication overdose in an infant due to inadequate parental education is discussed in this AHRQ WebM&M commentary.