High-alert medications for pediatric patients: an international modified Delphi study.
BACKGROUND
The available knowledge about high-alert medications for children is limited. Because children are particularly vulnerable to medication errors, a list of high-alert medication specifically for children would help to develop effective strategies to prevent patient harm. Therefore, we conducted an international modified Delphi study and validated the results with reports on medication incidents in children based on national data.


OBJECTIVE
The objective of this study was to generate an internationally accepted list of high-alert medications for a pediatric inpatient population from birth to 18-years old.


RESULTS
The rating panel consisted of 34 experts from 13 countries. In total, 14 medications and 4 medication classes were included with the predefined level of consensus of 75%. The high-alert medications were: amiodarone, digoxin, dopamine, epinephrine, fentanyl, gentamycin, heparine, insulin, morphine, norepinephrine, phenytoin, potassium, propofol and tacrolimus. The high-alert medication classes included in the final list were: chemotherapeutic drugs, immunosuppressive medications, lipid/total parenteral nutrition and opioids.


CONCLUSIONS
An international group of experts defined 14 medications and 4 medication classes as high-alert for children. This list might be helpful as a starting point for individual hospitals to develop their own high-alert list tailored to their unique situation.
Emma Children's Hospital, Academic Medical Center , PO Box 22660, 1100 DE Amsterdam , the Netherlands +31205668173 ; +31206917735 ; j.m.maaskant@amc.nl.
Jolanda M
JM
Maaskant
Anne
A
Eskes
Petra
P
van Rijn-Bikker
Diederik
D
Bosman
Wim
W
van Aalderen
Hester
H
Vermeulen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003697:Delphi Technique; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007391:International Cooperation; D008508:Medication Errors / Q000517:prevention & control*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*
D004364:Pharmaceutical Preparations