1 Department of Pediatrics, University Medical Center, Ann Arbor, Michigan
Accidents do occur with an alarming frequency to children who are in the hospital. Fortunately, the majority of such accidents do not result in any serious injury to the child. Nevertheless, many of them are potentially serious in nature. The medicolegal implications are of considerable importance to the hospital, physician, nurses, and other personnel. A very high percentage of the accidents can be traced directly or indirectly to errors on the part of these hospital personnel. The material presented in this survey is not complete but leads to certain conclusions.
1. There could be greater uniformity in accident reporting with an attempt to define an accident more specifically. It is felt that the actual number of accidents that occur in pediatric wards is probably much higher than indicated by this paper, but many accidents are not reported, since they do no actual injury to a patient.
2. Orientation toward accident prevention should be carried out and repeated at regular intervals for all hospital personnel. This should be designed to stress all potential dangers and to give all staff working in pediatric areas greater knowledge in this field.
3. The prevention of medication errors might be reduced by a number of factors. These include the preparation of medicaments in a more isolated area so that there is less opportunity for distraction. The orders required for any medicaments should be very specific. This is particularly true when parenteral fluids are administered, and this should include quantity, duration of administration, and the type of fluids or medicaments to be used. Finally, the stocking of pediatric dosages of commonly used medicines is to be encouraged.
4. The preparation of a detailed accident report by the person involved in each of the accidents, whether it is his fault or not, should be a required hospital procedure. One of the aims of such a report is to further education in this field, and secondly, to bring about solution to the repeated occurrence of a similar type of accident.
5. The formation of an accident committee to review data from accident reports and to inspect the pediatric areas in a hospital at regular intervals is highly recommended.
Submitted on March 22, 1963