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Unintended Errors Leave Many Newborns Vulnerable

FRIDAY Feb. 1, 2008 -- Iatrogenic events (IEs) -- unintended harm or suffering caused by health care -- occur frequently in newborn babies in hospitals, according to new French research.

These IEs are sometimes serious and often preventable, said the researchers at La Conception Hospital in Marseille, France.

They looked at 388 newborns admitted to a neonatal center in France between January and September 2005. During 10,346 patient days, there were 267 IEs in 116 of the newborns, a rate of 25.6 per 1,000 patient days. For this study, IEs were defined as any event that compromised the safety margin of a patient, whether or not they suffered harm.

Of the IEs recorded in the study, 92 (34 percent) were preventable, and 78 (29 percent) were severe. Two IEs were fatal, but neither was preventable. IEs most likely to be severe were nosocomial infections -- 49 of 62 were severe (79 percent) -- and respiratory events -- 9 of 26 (35 percent] ). Of the 34 adverse drug IEs, 19 were medication errors.

The researchers found that the leading risk factors for an IE among newborns were: low birth weight and gestational age; length of hospital stay; a central venous line; mechanical ventilation, and support with continuous positive airway pressure.

"A third of all iatrogenic events and more than a quarter of severe iatrogenic events were preventable. Iatrogenic events seem to be less preventable in neonates than in adults and children, in whom 40 to 60 percent of adverse events are preventable," the study authors wrote.

"The high risk of iatrogenic events draws attention to the importance of developing, testing, and implementing effective error-prevention strategies in pediatric medicine. Prospective, anonymous incident reporting offers both a means to monitor and prevent iatrogenic events, and an educational advantage to staff. Reduction of the rate of iatrogenic events in vulnerable, neonatal patients should be one of the main aims in providing best possible quality of health care for children," they concluded.

Their report is published in the Feb. 2 issue of The Lancet.

More information

The U.S. National Library of Medicine has more about infant and newborn care.

Posted: February 2008


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