Children are at high risk for medication errors in emergency departments (EDs). Physician prescribing has been implicated as the most common source of these errors. This retrospective study found that telemedicine consultations for pediatric critical care were associated with fewer physician-related medication errors among seriously ill children in rural EDs. Telemedicine consultations seemed to reduce medication errors more than traditional telephone consultations. Telemedicine may prove to be an important tool for improving the care of rural patients across many different scenarios.

This demonstration study suggests that after-hours telepharmacy review may provide an effective strategy for reducing medication errors at rural hospitals.

In the pediatric population, medication errors occur at rates similar to those of adults. However, given the need for careful weight-based dosing of medications for pediatric patients, fast-paced emergency department settings may increase this risk. In this study, two pediatric pharmacists used a data collection instrument to retrospectively characterize the frequency and nature of medication errors in more than 175 cases. Investigators discovered errors in half the patient cases where a medication was prescribed. Incorrect physician orders accounted for the most common error source. The authors advocate for system redesign to prevent such a high rate of errors, particularly in rural settings where resources may be limited.