Impact of an educational intervention on the reduction of adverse drug events: a quasi-experimental study in pediatric inpatient care

Consuelo Treviño-Garza, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Carlos A. Zapata-Castilleja, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Sara E. Borjon-Muñoz, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Yajaira V. Jimenez-Antolinez, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Leonor G. Hinojosa-Amaya, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Fernando F. Montes-Tapia, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Francesca Patiño-López, Department of Pediatrics, Autonomous University of Nuevo Leon, School of Medicine of the Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
Marina Riojas-Jaques, Department of Pediatrician and Nursing Administration, School of Medicine at the “Dr. José E. González” University Hospital, Monterrey, Nuevo León, Mexico

Background: Adverse events represent one of the main threats to health in low and middle resource countries; adverse drug events (ADEs) are frequent in hospitalized pediatric patients, so the objective of the study was to assess the impact of an educational intervention for healthcare personnel on the incidence of AEs related to prescribing and administration in the pediatric inpatient service of a tertiary public university hospital. Methods: A quasi-experimental before-and-after study was conducted in a pediatric inpatient unit. Eight experts analyzed adverse events (AEs) documented in the Computerized Physician Order Entry and Electronic Medical Record systems, categorizing them using a risk matrix. The most common incidents were related to prescription and medication administration. Three training courses were provided to residents and nursing staff by specialists, focusing on the safe handling of cytotoxics, insulins, and concentrated electrolytes while reinforcing the “five rights” principle and the use of double-check lists. Competence was evaluated through pre- and post-course questionnaires. Preventable events from 2022 and 2023 were compared using the X2/Fisher’s exact test, with significance established at p < 0.05 (Statistical Package for the Social Sciences v25). Results: The educational intervention led to a significant reduction in AEs related to administration and prescription. Incidence rates decreased from 60% to 30% (p = 0.0007) for administration and from 23% to 6% (p = 0.006) for prescription. Nursing staff primarily reported these AEs, with higher reporting rates observed during daytime shifts. Conclusions: The educational intervention significantly reduced drug-related events in pediatric hospitalization and enhanced the role of nursing staff in ensuring safety during daytime shifts. Further research is needed to validate these findings.

Keywords: Adverse drug event. Patient safety. Quality of care. Medication errors. Pediatrics.