Prevalence, Causes and Severity of Medication Administration Errors in the Neonatal Intensive Care Unit: A Systematic Review and Meta-Analysis

Josephine Henry Basil, Chandini Menon Premakumar, Adliah Mhd Ali, Nurul Ain Mohd Tahir and Noraida Mohamed Shah ()
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Josephine Henry Basil: Universiti Kebangsaan Malaysia
Chandini Menon Premakumar: Universiti Kebangsaan Malaysia
Adliah Mhd Ali: Universiti Kebangsaan Malaysia
Nurul Ain Mohd Tahir: Universiti Kebangsaan Malaysia
Noraida Mohamed Shah: Universiti Kebangsaan Malaysia

Drug Safety, 2022, vol. 45, issue 12, No 3, 1457-1476

Abstract: Abstract Introduction Neonates are at greater risk of preventable adverse drug events as compared to children and adults. Objective This study aimed to estimate and critically appraise the evidence on the prevalence, causes and severity of medication administration errors (MAEs) amongst neonates in Neonatal Intensive Care Units (NICUs). Methods A systematic review and meta-analysis was conducted by searching nine electronic databases and the grey literature for studies, without language and publication date restrictions. The pooled prevalence of MAEs was estimated using a random-effects model. Data on error causation were synthesised using Reason’s model of accident causation. Results Twenty unique studies were included. Amongst direct observation studies reporting total opportunity for errors as the denominator for MAEs, the pooled prevalence was 59.3% (95% confidence interval [CI] 35.4–81.3, I2 = 99.5%). Whereas, the non-direct observation studies reporting medication error reports as the denominator yielded a pooled prevalence of 64.8% (95% CI 46.6–81.1, I2 = 98.2%). The common reported causes were error-provoking environments (five studies), while active failures were reported by three studies. Only three studies examined the severity of MAEs, and each utilised a different method of assessment. Conclusions This is the first comprehensive systematic review and meta-analysis estimating the prevalence, causes and severity of MAEs amongst neonates. There is a need to improve the quality and reporting of studies to produce a better estimate of the prevalence of MAEs amongst neonates. Important targets such as wrong administration-technique, wrong drug-preparation and wrong time errors have been identified to guide the implementation of remedial measures.

Date: 2022
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DOI: 10.1007/s40264-022-01236-6

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