Hospital Fixes Cut Opiate Errors in Kids

MONDAY Oct. 6, 2008 -- Simple changes to hospital procedures can significantly reduce the side effects children suffer while on opiates to relieve pain, a new study reveals.

The study, a yearlong collaboration between 14 U.S. children's hospitals, documented a 67 percent decrease in "harmful events" caused by the pain relievers under these new procedures.

The side effects of opiates in the morphine family -- which are widely used to relieve serious pain in children -- range from minor, such as constipation and itching, to rare instances of serious harm, such as a decreased urge to breathe.

"Our focus was not only on errors, but also on harm to patients," study senior author Frank Federico, a pharmacist and medication safety expert with the Institute for Healthcare Improvement in Cambridge, Mass., said in a news release issued by one of the participating hospitals.

For example, in this study, physicians started patients on laxatives and stool softeners as soon as they began opiate prescriptions to head off any possible issues with constipation, which -- while not serious -- is considered a harmful incident by study standards.

The teams also reduced prescription overrides, in which nurses gave pain medications to children before double-checking with a pharmacist, and worked diligently to ensure the child's caregiver had up-to-date drug lists when he or she was admitted to the hospital, transferred to a new ward, and sent home.

The researchers estimated that these efforts averted 14,594 harmful events in participating hospitals during the one-year study, which was organized by the Child Health Corporation of America, a business alliance of 44 North American children's hospitals.

The changes also saved hospitals money, since side effects from medications can be costly to resolve and often result in extended hospital stays, the team reported.

The findings were expected to be published in the October issue of Pediatrics.

More information

The Nemours Foundation has more about children's health issues.

Posted: October 2008


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