Intravenous fluid prescribing errors in children: Mixed methods analysis of critical incidents

Richard L. Conn, Steven McVea, Angela Carrington, Timothy Dornan

Research output: Contribution to journalArticle

2 Citations (Scopus)
381 Downloads (Pure)

Abstract

Introduction: Recent National Institute for Health and Care Excellence (NICE) guidelines aim to improve intravenous (IV) fluid prescribing for children, but existing evidence about how and why fluid prescribing errors occur is limited. Studying this can lead to more effective implementation, through education and systems design.

Aims:
1. Identify types of IV fluid prescribing errors reported in practice
2. Analyse factors that contribute to errors
3. Provide guidance to educators and those responsible for designing systems

Methods: Mixed methods observational study which analysed critical incident reports relating to IV fluid prescribing errors in children aged 0±16, occurring between 2011 and 2015 in UK secondary care. We quantified characteristics and types of errors, then qualitatively analysed narrative descriptions, identifying underlying contributing factors.

Results: In the 40 incidents analysed, principal types of errors were incorrect rate of fluids, inappropriate choice of solution, and incorrect completion of prescription charts. Prescribers had to negotiate complex patients, interactions with other practitioners and teams, and challenging work environments; errors resulted from these inter-related contributing factors.

Conclusions: This study highlights the diverse range and complex nature of IV fluid prescribing errors reported in practice. While these findings have the inherent limitations of critical incident
Original languageEnglish
Article numbere0186210
Pages (from-to)1-12
JournalPLoS ONE
Volume12
Issue number10
DOIs
Publication statusPublished - 12 Oct 2017

Keywords

  • Prescribing
  • Education, Medical

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