Globally, healthcare systems with primary care-led models of
delivery must examine their existing practices to determine the
prevalence and burden of safety issues for children.
An analysis of patient safety incidents involving sick children in England and Wales, published in PLOS Medicine
by Dr. Philippa Rees from Cardiff University, UK, and colleagues,
reveals areas where primary care providers can improve in their care of
children to reduce adverse events.
‘Areas where primary care providers can improve in their care of children to reduce adverse events has been revealed by a new study.’
In the new study, researchers reviewed primary care patient safety
reports involving children under age 18 that had been submitted by
healthcare professionals to England and Wales' National Reporting and
Learning Service between 2003 and 2013.
Of the 2191 safety incidents
studied, 658 (30%) were harmful, including 12 deaths.
in adverse events were most often being seen for respiratory conditions,
including asthma and coughs; injuries, including head and limb injuries
and accidental overdoses; and non-specific symptoms, such as fever or
weight loss. Primary incident types were dominated by errors in
medication (31.9%) - such as children being prescribed the wrong dose
of a drug - and errors in diagnosis and assessment (23.4%), which often
led to the delayed management of conditions.
The study is limited by possible under-reporting of some types of
safety incidents, but the new analysis led the researchers to identify
priority areas for improvement in the care of children, including: safer
systems for medication provision in community pharmacies; better triage
processes during out-of-hours services; and enhanced communication
between professionals and parents.
In an accompanying Perspective, Gordon Schiff discusses the
challenge of pulling meaningful data from patient safety reports as well
as the idea that adverse events being reported are not necessarily
representative of all errors occurring. Those challenges
notwithstanding, he says the new study "is valuable for both the
specific findings, lessons, and insights, but also for encouraging us to
grapple with the value of such reporting systems, analysis of collected
reports, and ways of better leveraging findings to prevent harm in the