An accurate weight is critical for dosing medications in children. Weight errors can lead to medication-dosing errors.
This study examined the frequency and consequences of weight errors occurring at 1 children's hospital and 2 general hospitals.
Using an electronic medical record database, 79,000 emergency department encounters of children younger than 5 years were analyzed. Extreme weights were first identified using weight percentiles. Encounters with potential weight errors were further evaluated using a retrospective chart review to determine whether a weight error and medication-dosing error occurred.
The percentage of weight errors of total encounters at all 3 institutions was low (0.63% on average), but a large proportion of weight errors led to subsequent medication-dosing errors (34% on average). The children's hospital did not have clinically significantly lower occurrences of weight errors or weight-based medication errors. Common weight errors included the weight in pounds being substituted for the weight in kilograms and decimal placement errors.
Weight errors were uncommon at the 3 emergency departments that we studied, but they led to weight-based medication-dosing errors that had the potential to cause harm.
From the Department of Pediatrics, University of Hawai'i John A. Burns School of Medicine, Kapi'olani Medical Center for Women & Children, Honolulu, HI.
This study was supported by Hawai'i Pacific Health's Summer Student Research Program.
Disclosure: The authors declare no conflict of interest.
Reprints: Loren G. Yamamoto, MD, MPH, MBA, Department of Pediatrics, University of Hawai'i John A. Burns School of Medicine, 1319 Punahou St, 7th Floor, Honolulu, HI 96826 (e-mail: Loreny@hawaii.edu).