Effect of a drug dosing safety bundle initiative to improve pediatric drug dosing by paramedics. Results of the Michigan Pediatric EMS Error Reduction Study (MI-PEERS)

Key Points

• To evaluate the effectiveness of a drug dosing safety bundle initiative in reducing drug dosing errors by paramedics treating pediatric patients.
• Evaluated a multi-component drug dosing safety decision support system (DDSS)
• Assessed drug dosing error rates before and after the intervention
• Monitored specific errors related to anaphylaxis treatment
• Compared error rates between crews using the DDSS checklist and those who did not
• No overall reduction in drug dosing error rates was observed
• Significant decrease in errors of omission for anaphylaxis treatment
• Crews using the DDSS checklist had lower drug dosing error rates
• Identified serious safety threat regarding D10 administration to pediatric patients
• Recommended replacing D10 with D10 normal saline as a system-based intervention