Medication errors in a neonatal unit: One of the main adverse events

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Esqué Ruiz, M.G. Moretones Suñol, J.M. Rodríguez Miguélez, E. Sánchez Ortiz, M. Izco Urroz, M. de Lamo Camino, J. Figueras Aloy" "autores" => array:7 [ 0 => array:4 [ "nombre" => "M.T." "apellidos" => "Esqué Ruiz" "email" => array:1 [ 0 => "mtesque@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M.G." "apellidos" => "Moretones Suñol" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Rodríguez Miguélez" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Sánchez Ortiz" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Izco Urroz" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "de Lamo Camino" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "Figueras Aloy" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio Neonatología, ICGON, BCNatal, Hopital Clínic sede Maternitat, Universidad de Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Los errores de tratamiento en una unidad neonatal, uno de los principales acontecimientos adversos" ] ] "textoCompleto" => "IntroductionNeonatal units, and especially the sections devoted to intensive care, are among the hospital settings where treatment errors are most likely to occur. Among the latter, medication errors (MEs) are part of an emergent pathology that has received increasing attention from health professionals, organisations and authorities in recent years,<a class="elsevierStyleCrossRef" href="#bib0180">1</a> as they constitute a serious health problem in hospitalised patients,<a class="elsevierStyleCrossRef" href="#bib0185">2</a> and one that is underestimated in the paediatric and neonatal populations.<a class="elsevierStyleCrossRef" href="#bib0190">3</a>A ME is defined as any preventable event secondary to the misuse of a medication that may cause or lead to patient harm<a class="elsevierStyleCrossRef" href="#bib0195">4</a>; on the other hand, an adverse drug event (ADE) is defined as any harm, severe or mild, caused by the use (or lack thereof) of a drug,<a class="elsevierStyleCrossRef" href="#bib0200">5</a> and an adverse drug reaction as a non-preventable response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease or for modification of physiological function.<a class="elsevierStyleCrossRefs" href="#bib0205">6,7</a>It is estimated that MEs occur eight times more often in neonatal intensive care units (NICUs) than in adults in hospital.<a class="elsevierStyleCrossRef" href="#bib0215">8</a> The drug administration protocols in the neonatal period diverge from those applied in other age groups due to the lack of dosage forms fitting the needs of neonates,<a class="elsevierStyleCrossRefs" href="#bib0215">8,9</a> their different physiology, and the fact that they are a population of heterogeneous and changing individuals that require different regimens depending on their pathology, weight, gestational age and days of life. Treating these patients requires measuring small volumes, dividing unit doses into fractions and performing complex dilutions, and the bioavailability after such manipulations is often unknown and unpredictable and may result in the use of toxic or ineffective doses. This, compounded by the variability in the pharmacokinetic and pharmacodynamic processes of the drugs (preservatives, stabilisers, etc.),<a class="elsevierStyleCrossRef" href="#bib0220">9</a> the greater severity of disease, the longer length of stay and the impossibility of communicating with the patient among other factors make detecting errors more difficult. In this regard, Cotrina Luque et al. have developed a model list of high-risk drugs in the neonatal and paediatric populations, which they defined as those that may cause severe harm or even death when misused.<a class="elsevierStyleCrossRef" href="#bib0225">10</a>Medication errors can occur at different points in care delivery, from the time of prescribing to the time of administration. Although prescribing, dispensing and administration are particularly important in the neonate, the causes of errors<a class="elsevierStyleCrossRef" href="#bib0230">11</a> often occur earlier (labelling, packaging, names). For all the above reasons, the frequency with which they occur<a class="elsevierStyleCrossRefs" href="#bib0235">12,13</a> and their potential seriousness, the prevention of MEs must be addressed with a multidisciplinary approach.<a class="elsevierStyleCrossRef" href="#bib0245">14</a>It is widely accepted that improving patient safety requires identifying and analysing errors and implementing the measures needed to prevent their reoccurrence. The aim of our study was to analyse the MEs that occurred in a department of neonatology, the medications involved, the severity of the errors and the potential for preventing them, and to describe the strategies implemented for their prevention.Materials and methodsIn the Department of Neonatology, the Committee for Patient Safety (Comisión para la Seguridad del paciente neonatal [CSPN]), which started to operate in 2008, created a voluntary AE reporting system.<a class="elsevierStyleCrossRef" href="#bib0250">15</a> As data were collected on the reported AEs, they were analysed and preventive measures implemented. To facilitate their study, the AEs were entered into a Microsoft Office Access 2003 database and classified into events concerning patient identification, diagnosis, treatment (due to medications or other therapies), procedures (diagnostic and therapeutic) or equipment and devices.Using the tools of the software application, we selected the MEs based on the definition given in the introduction and classified them as prescribing or administration errors; by the involved product (drugs, nutrition products, parenteral nutrition products, intravenous fluids, blood products, nitric oxide, oxygen, sucrose, others); the type of error (incorrect dose, delay in administration, incorrect route or rate of administration, medication or dose omission, inappropriate, deteriorated or expired medication, etc.); the setting where the error took place (intensive or intermediate care unit, etc.). Due to the importance of nutrition for the adequate somatic and neurologic development of the preterm neonate, nutrition products are considered as medication in this early stage of life.<a class="elsevierStyleCrossRefs" href="#bib0240">13,16</a> With regard to the health care staff, we collected data on the type of professional that made the report, whether the reporter was directly involved or not in the AE, and the reporter's seniority (<5 years, 5–10 years, >10 years). We analysed the contributing factors related to the health professionals (distraction, repetitiveness, inadequate training, personal factors, communication problems), organisational factors (excessive workloads, lack of protocols, infrastructure, environmental factors, human resources, other causes) and factors related to equipment and devices. We assessed the impact on the patient according to the scale developed by Hartwig et al.<a class="elsevierStyleCrossRef" href="#bib0260">17</a> We classified the measures that were adopted to correct these errors into three categories: simple (direct notification, safety alerts, correct labelling, use of posters, checking equipment and materials, etc.), intermediate (protocols, monthly bulletin, clinical sessions, courses, etc.) and high-level (manuals, root cause analyses, annual conferences, prospective studies, round tables, etc.).In the analysis of MEs, we studied whether they had been intercepted, that is, whether they had been detected before reaching patients, and whether they were preventable. We also analysed preventability, retrospectively applying an adaptation to neonatology of the table proposed by Otero-López et al.,<a class="elsevierStyleCrossRef" href="#bib0185">2</a> which in turn was an adaptation of the questionnaire developed by Schumock and Thornton.<a class="elsevierStyleCrossRef" href="#bib0265">18</a>ResultsWe analysed the AEs reported between February 1, 2008 and January 31, 2015. We classified the 4575 newborns admitted to the neonatology department for a total of 73,840 patient days during this seven-year period based on whether they stayed in the intensive care unit (2212 patients admitted for 13,579 patient days) or the intermediate care unit (4575 patients admitted for 60,261 days). Of the 1628 reported AEs, 511 (31.4%) were MEs (6 MEs per month under study). The incidence of MEs reported in the intensive care unit was 32.2 per 1000 patient days (19.7 MEs per 100 admitted newborns). Of all the MEs we identified, 39.5% were prescribing errors and 68.1% administration errors, while 3 events (0.6%) were finally classified as ADRs (unpreventable) as opposed to MEs.<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the characteristics of the errors: product involved, type of error, setting of error, seniority of involved professional, type of professional that made the report, and whether the error was intercepted. It is worth noting that 65.4% of MEs involved drugs, most frequently antibiotics (86 MEs), and gentamicin (29 MEs) and vancomycin (17 MEs) in particular, with most errors consisting of wrong dosing frequency. Thirty-four reports involved sedation and analgesia (the product involved in 26 was fentanyl). Other involved drugs were caffeine (22 MEs), diuretics (18 MEs), eye drops (14 MEs), inotropes (12 MEs), insulin (12 MEs) and indometacin (6 MEs).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>When it came to the type of error, the most frequent was incorrect dosing (33.1%). The errors were intercepted in 17% of cases. Most MEs occurred in the intensive care unit (72%). The group of professionals for which errors were least frequently reported was the group with 5–10 years of seniority (21.6%). Nursing staff made 69.5% of the reports.<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarises the impact on the patient according to the severity-index scale developed by Hartwig et al.<a class="elsevierStyleCrossRef" href="#bib0260">17</a> Of all errors, 10.6% harmed the patient (8.32 MEs per 1000 patient days), and 0.6% (0.22 per 1000 days) may have contributed to the development of permanent sequelae or death (severity levels 5–6). The possible causes for MEs are summarised in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. Factors related to the health care professional were documented in 89% of the reports, with distraction being the most frequent cause (59%). Of the errors related to organisational factors (18.8%), most were due to excessive workloads (8.6%).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>We considered 99.4% of MEs preventable after reviewing them using the table adapted from Otero-López et al.<a class="elsevierStyleCrossRef" href="#bib0185">2</a><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents the results of this analysis. The only events that could not be classified in this table were the three identified as ADRs.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>The strategies implemented for the prevention of MEs included 205 simple measures (alerts, recommendations) and 299 intermediate measures (protocols, clinical sessions, courses, etc.), and the high-level strategies included four root cause analyses and the production of a monograph on the administration of intravenous drugs in the newborn, written by a group of nurses in the unit and made available in laminated format for consultation in the department and in pocket format for its distribution to every staff member. Due to the inherent characteristics of the ME identification system, it is not possible to assess the impact of these actions on the reduction of MEs.DiscussionComparisons between studies are difficult due to the differences in the data collection methods and definitions used in each of them. According to Suresh, the number of AEs that are detected and documented depends on the strategies implemented for their identification, and considering the variability in the approaches of different studies,<a class="elsevierStyleCrossRef" href="#bib0270">19</a> comparisons with other studies would be less pressing than finding the errors that occur in house and for prevention strategies to be accepted.In the analysis by Snijders et al., of 4846 voluntary incident reports corresponding to 3859 admissions, 27% were medication errors,<a class="elsevierStyleCrossRef" href="#bib0235">12</a> a figure similar to the one found in our study (32.2%). The rate of MEs is much higher in studies in which voluntary reporting is used compared to studies that use data from mandatory reporting systems (13–14.7 versus 0.97 per 1000 patients/day in the NICU).<a class="elsevierStyleCrossRef" href="#bib0275">20</a> This could be explained by the fact that mandatory reporting focuses on errors that produce permanent harm or death while voluntary reporting includes near-misses and low-severity events, and when trigger tools are used to investigate the circumstances that may cause AEs, the number of reports is much higher than that obtained through mandatory reporting.<a class="elsevierStyleCrossRef" href="#bib0280">21</a>Suresh et al. found that MEs (including errors involving nutrition and blood products) are the most frequent cause of AEs (47%).<a class="elsevierStyleCrossRef" href="#bib0240">13</a> Extremely preterm newborns require optimal nutritional support for adequate development, be it fortified human milk or special formulas, so nutrition products are considered medication<a class="elsevierStyleCrossRef" href="#bib0255">16</a> and errors involving them MEs. A recent study by De Franco et al. described a rate of errors of 43 per 100 patients in the NICU, 48% of which were administration errors.<a class="elsevierStyleCrossRef" href="#bib0285">22</a> Ligi et al. reported an incidence of 4.9 MEs per 100 admissions. The most frequent errors were administration errors, almost all of which were programming mistakes of pumps.<a class="elsevierStyleCrossRef" href="#bib0290">23</a> Campino et al. analysed 91 medication samples, 52 of vancomycin and 39 of tobramycin, and detected calculation mistakes in 4.6% of the samples and precision errors in 37.9%. The authors concluded that while the detected errors had not resulted in evident harm to the patient, they had the potential to cause severe complications, and underscored the urgency of improving the methods used to prepare intravenous medications at the bedside.<a class="elsevierStyleCrossRef" href="#bib0295">24</a>In our study, administration errors (68.1%) were also more frequent than prescribing errors (39.5%), and incorrect dosing was the most frequent error in both categories (51.5%), a finding consistent with the results of a study conducted in Hong Kong paediatric wards by Rashed et al. (42.7%).<a class="elsevierStyleCrossRef" href="#bib0300">25</a> Horri et al. found a rate of dosing errors of 3.8 and 3.1 per 100 manual prescriptions for preterm newborns less than 33 weeks’ gestational age in two NICUs, and concluded that manual prescriptions should be forbidden in neonatal units.<a class="elsevierStyleCrossRef" href="#bib0305">26</a> In our study, 32.2% of prescribing errors were intercepted, a low percentage compared to the one found in the study by De Franco et al., in which 63% were intercepted.<a class="elsevierStyleCrossRef" href="#bib0285">22</a>Seventy-two percent of the reported MEs took place in the NICU, which was expected on account of the polymedication of patients in this unit.Nurses reported errors twice as frequently as physicians (69.5% compared to 30.4%). Guerrero-Aznar et al. found that nurses reported errors 11 times as frequently as physicians.<a class="elsevierStyleCrossRef" href="#bib0310">27</a>Neither the seniority or the inexperience of health care professionals were protective factors associated with fewer errors; on the contrary, the group reported to make the least errors corresponded to professionals with 5–10 years of seniority (21.6%). In an analysis of 6749 MEs, Stavroudis et al. identified human factors as the most frequent cause of errors (68.4%),<a class="elsevierStyleCrossRef" href="#bib0315">28</a> while in our study, we found that factors related to health care professionals were noted in 90% of the reports, and organisational factors in 18.8% of reports.Fortunately, a high percentage of MEs did not lead to harm (89.4%), but we must succeed in reducing these too, as failing to do so is indicative of low-quality care.<a class="elsevierStyleCrossRef" href="#bib0180">1</a> There is evidence that AEs result from a combination of deficiencies in the system and errors made by professionals.<a class="elsevierStyleCrossRef" href="#bib0320">29</a> Analysing potential MEs is useful because it allows the identification of break points in the system as well as points where the system works, which can help intercept errors. It is widely accepted that 1%–5% of MEs may cause harm to the patient,<a class="elsevierStyleCrossRef" href="#bib0325">30</a> so barriers must be set up to prevent their occurrence.Multiple measures have been undertaken to reduce MEs, the most salient being the production of a monograph on the administration of intravenous drugs in newborns written by a group of nurses that work in the unit that were not members of the CSPN but were pursuing the same goals. Comparing the present and past outcomes of our institution is difficult, because as the safety culture grows, the number of voluntary reports increases, masking the progressive improvement.The currently used strategies of the “six rights” (right individual, right medication, right dose, right time, right route, right documentation) and the “four I's” (I prepare, I administer, I document, I am responsible) are considered insufficient to succeed in reducing the incidence of MEs, as this not only requires safe medications and procedures, but also the creation of fail-safe systems with integrated safety measures and devices that can reduce errors to the maximum or ensure that they do not reach the patient.<a class="elsevierStyleCrossRefs" href="#bib0180">1,19</a>The strategies to prevent MEs must include the development and use of protocols, staff training, and the involvement of the health authorities, medicine regulatory agencies, and pharmaceutical companies.<a class="elsevierStyleCrossRef" href="#bib0180">1</a> Drug formulations adapted to neonates, the preparation of unit doses, the specificity of routes of administration, the use of automated systems and digital identification, electronic prescription, a broad training programme,<a class="elsevierStyleCrossRefs" href="#bib0330">31,32</a> continuous monitoring of AEs<a class="elsevierStyleCrossRef" href="#bib0335">32</a> and having a hospital pharmacist on staff<a class="elsevierStyleCrossRefs" href="#bib0330">31,33</a> contribute effectively to reducing MEs in the paediatric population and especially in the neonatal subset.<a class="elsevierStyleCrossRef" href="#bib0345">34</a>The high technological complexity of neonatal care requires up-to-date knowledge and the protocolisation, assessment and analysis of the work performed. The detection of errors must not lead to assigning blame, but to their analysis and correction, improving communication between professionals and promoting better practices. We need not only create a safety culture, which refers to the values it is founded on, but also a safety climate, focused on the concepts of productiveness and efficacy, and with particular emphasis on the prevention of MEs.<a class="elsevierStyleCrossRefs" href="#bib0270">19,35</a>Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres623589" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec637218" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres623590" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec637219" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-05-26" "fechaAceptado" => "2015-09-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec637218" "palabras" => array:10 [ 0 => "Treatment errors" 1 => "Medication errors" 2 => "Prescription errors" 3 => "Administration errors" 4 => "Culture of safety" 5 => "Newborn" 6 => "Adverse events" 7 => "Prevention" 8 => "Critical incident reporting" 9 => "Drug safety" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec637219" "palabras" => array:10 [ 0 => "Errores de tratamiento" 1 => "Errores de medicación" 2 => "Errores de prescripción" 3 => "Errores de administración" 4 => "Cultura de seguridad" 5 => "Recién nacido" 6 => "Acontecimientos adversos" 7 => "Prevención" 8 => "Declaración de acontecimientos adversos" 9 => "Seguridad en la medicación" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionNeonatal units are one of the hospital areas most exposed to committing treatment errors. A medication error (ME) is defined as the avoidable incident secondary to drug misuse that causes or may cause harm to the patient.The aim of this paper is to present the incidence of ME (including feeding) reported in our neonatal unit and its characteristics and possible causal factors. A list of the strategies implemented for prevention is presented. Material and methodsAn analysis was performed on the ME declared in a neonatal unit. ResultsA total of 511 MEs were reported over a period of seven years in the neonatal unit. The incidence in the critical care unit was 32.2 per 1000 hospital days or 20 per 100 patients, of which 0.22 per 1000 days had serious repercussions. The MEs reported were, 39.5% prescribing errors, 68.1% administration errors, 0.6% were adverse drug reactions. Around two-thirds (65.4%) were produced by drugs, with 17% being intercepted. The large majority (89.4%) had no impact on the patient, but 0.6% caused permanent damage or death. Nurses reported 65.4% of MEs. The most commonly implicated causal factor was distraction (59%). Simple corrective action (alerts), and intermediate (protocols, clinical sessions and courses) and complex actions (causal analysis, monograph) were performed. ConclusionsIt is essential to determine the current state of ME, in order to establish preventive measures and, together with teamwork and good practices, promote a climate of safety." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLas unidades neonatales son uno de los ámbitos hospitalarios más expuestos a la comisión de errores de tratamiento. El error de medicación (EM) se define como el incidente, evitable, secundario a la utilización inapropiada de medicamentos, que causa o puede causar daño al paciente.El objetivo de este trabajo es dar a conocer la incidencia de EM (incluida la alimentación) notificados en nuestra unidad neonatal así como sus características y posibles factores causales. Así mismo se expone una relación de las estrategias llevadas a cabo para su prevención. Material y métodosSe analizan los EM declarados en un servicio de neonatología. ResultadosDurante un período de 7 años, en el servicio de neonatología se han notificado 511 EM. La incidencia en la unidad de críticos fue de 32,2 por 1.000 días de hospitalización o 0,2 por paciente, de los cuales 0,22 por 1.000 días tuvieron repercusión grave; el 39,5% fueron errores de prescripción, el 68,1% de administración y el 0,6% reacciones adversas a medicamentos. El 65,4% fue producido por fármacos. Se interceptó el 17%. El 89,4% no tuvo repercusión sobre el paciente; el 0,6% causó secuelas permanentes o muerte. Los profesionales de enfermería declararon el 65,4% de los EM. El factor causal más frecuentemente implicado fue la distracción (59%). Se realizaron medidas correctoras simples (alertas), intermedias (protocolos, sesiones clínicas, cursos) y complejas (análisis causales, monografía). ConclusionesEs imprescindible conocer la propia realidad para poder establecer medidas preventivas y, junto al trabajo en equipo y las buenas prácticas, promover un clima de seguridad." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Esqué Ruiz MT, Moretones Suñol MG, Rodríguez Miguélez JM, Sánchez Ortiz E, Izco Urroz M, de Lamo Camino M, et al. Los errores de tratamiento en una unidad neonatal, uno de los principales acontecimientos adversos. An Pediatr (Barc). 2016;84:211–217." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prescription 202 (39.5%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Administration 348 (68.1%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> n=511 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">By product</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Drugs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">160 (79.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">208 (59.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">334 (65.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nutrition product \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (5.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 (13.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63 (12.3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Parenteral nutrition product \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 (12.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (9.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">IV fluids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (8.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (9.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 (8.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Blood products \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (3.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (3.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">iNO \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Oxygen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (0.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (0.86%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (0.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">By type of error</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Delay in administration \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (8.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 (16.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 (14.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Incorrect route \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (3.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (3.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Incorrect rate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (8.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (13.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 (10.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Medication or dose omission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 (20.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 (20.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">103 (20.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Incorrect medication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (8.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (8.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 (8.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Deteriorated or expired medication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (2.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (2.3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Incorrect dose \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">104 (51.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">112 (32.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">169 (33.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Illegible prescription \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (4.4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 (2.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (2.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other causes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">By the setting where error was made</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intensive care unit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">140 (69.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">262 (75.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">368 (72%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intermediate care unit \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 (28.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">77 (22.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">129 (26%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (4.02%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (4.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Seniority of professional</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><5 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62 (30.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 (26.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">139 (32.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5–10 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 (15.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">73 (21%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92 (21.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">>10 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">83 (41.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">126 (36.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">195 (45.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not documented \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (12.9%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56 (16.1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">85 (16.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Reported by</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Physician \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 (29.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">72 (20.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">121 (30.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Nurse \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">103 (51%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">183 (52.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">277 (69.5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Not documented/other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (19.8%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93 (26.7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">113 (22.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intercepted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 (32.2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (6.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87 (17%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1023025.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Some cases correspond to errors in both prescription and administration." ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of reported medication errors." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "Source: Hartwig et al.<a class="elsevierStyleCrossRef" href="#bib0260">17</a>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Impact of medication errors on patient outcomes n=511</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">No harm: 457 (89.4%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">The error did not reach the patient. Intercepted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">The error reached the patient but caused no harm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">272 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">The error resulted in the need for increased monitoring of the patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Harm: 54 (10.6%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Change in vital signs or need for additional blood draws for laboratory monitoring \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Error requiring treatment with another medication or that increased the length of stay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Error that resulted in permanent harm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Error that contributed to the death of the patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0010">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1023027.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "In one case, delay in the assessment of a newborn with a blood culture positive for Escherichia coli. Severe hypercalcaemia due to excessive calcium supplementation in preterm newborn with a weight of 700g and 25 weeks’ gestational age." ] ] ] "descripcion" => array:1 [ "en" => "Impact of medication errors on patient outcomes based on the Hartwig scale." ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Staff-related factors<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">460 (90%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Distraction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">306 (59.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Training \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98 (19.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Personal factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91 (17.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Communication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (9.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Repetitive work \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68 (13.3%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Team work \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (9.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patient information \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (0.98%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fatigue \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (0.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Organisational factors<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96 (18.8%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Excessive workload \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 (8.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Lack of protocols \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (2.1%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Infrastructure \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (4.9%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Environmental factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (1.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Human resources \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (1.6%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other causes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (1.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Factors related to equipment, devices, etc. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (0.2%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Factors related to the patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (0.4%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Factors related to medications \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 (10%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1023026.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "Some errors involved different causal factors." ] ] ] "descripcion" => array:1 [ "en" => "Causes associated with the medication errors (n=511)." ] ] 3 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Adapted from Schumock and Thornton.<a class="elsevierStyleCrossRefs" href="#bib0180">1,18</a>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A MRAE is considered potentially preventable when one or more of the following questions can be answered in the affirmative: \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total number of affirmative answers \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the drug involved in the MRAE not considered appropriate for the patient's clinical condition? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the dose, route, and frequency of administration not appropriate for the patient's age, weight or underlying disease? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">268 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the duration of treatment longer or shorter than the one established for the indication for which the drug was prescribed? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">132 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Were the clinical tests required for monitoring treatment not performed? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the patient have a previous history of allergic reaction or a similar adverse reaction to the same medication or to a medication with which it is cross-reactive or that have the same mechanism of action? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE occur as a result from some type of interaction? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Were potentially toxic serum concentrations of the drug or other abnormal results detected in the laboratory tests performed for therapeutic drug monitoring? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the preventive treatment required to prevent the adverse reaction not performed when the patient met the criteria to receive it? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from poor compliance with the prescription? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from an error in the administration of the drug? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from a circumstance that could be considered an error? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1023028.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Criteria used to classify medication-related adverse events (MRAEs) according to their preventability." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0180" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acontecimientos adversos por medicamentos: una patología emergente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. Otero" 1 => "A. Domínguez-Gil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Farm Hosp" "fecha" => "2000" "volumen" => "24" "paginaInicial" => "258" "paginaFinal" => "266" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0185" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acontecimientos adversos prevenibles causados por medicamentos en pacientes hospitalizados" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.J. Otero-López" 1 => "P. Alonso-Hernández" 2 => "J.A. Maderuelo-Fernández" 3 => "B. Garrido-Corro" 4 => "A. Dominguez-Gil" 5 => "A. Sánchez-Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2006" "volumen" => "126" "paginaInicial" => "81" "paginaFinal" => "87" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0190" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nature of medication errors in neonatal intensive care with strategies to improve safety. A review of the current literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Chedoe" 1 => "A. Harry" 2 => "H. Molendijk" 3 => "T.A.M. Dittrich" 4 => "F.G.A. Jansman" 5 => "J.W. Harting" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Drug Saf" "fecha" => "2007" "volumen" => "30" "paginaInicial" => "503" "paginaFinal" => "516" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17536876" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0195" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NCCMERP taxonomy of medications errors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "National Coordinating Council for Medication Error Reporting and Prevention" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "1998" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0200" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breakthrough series guide: reducing adverse drug events" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.L. Leape" 1 => "A. Kabcenell" 2 => "D.M. Berwick" 3 => "J. Roessner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1998" "editorial" => "Institute for Healthcare Improvement" "editorialLocalizacion" => "Boston" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0205" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Requirements for adverse reaction reporting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1975" "editorial" => "World Health Organization" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0210" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Errores de medicación: estandarización de la terminología y clasificación. Resultados de la Beca Ruiz-Jarabo 2000" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.J. Otero-López" 1 => "C. Codina Jané" 2 => "M.J. Tamés Alonso" 3 => "M. Pérez Encinas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Farm Hosp" "fecha" => "2003" "volumen" => "27" "paginaInicial" => "137" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12835826" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0215" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medication errors in the neonatal intensive care unit: special patients, unique issues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.E. Gray" 1 => "D.A. Goldmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2003.046060" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "2004" "volumen" => "89" "paginaInicial" => "F472" "paginaFinal" => "F473" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15499131" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0220" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "¿Tienen los recién nacidos las mismas oportunidades farmacoterapéuticas que los adultos?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Campino Villegas" 1 => "M.C. López Herrera" 2 => "M.I. Caballero" 3 => "M. García Franco" 4 => "I. López de Heredia y Goya" 5 => "A. Valls i Soler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2006" "volumen" => "64" "paginaInicial" => "428" "paginaFinal" => "432" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0225" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lista modelo de medicamentos de alto riesgo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Cotrina Luque" 1 => "M.D. Guerrero Aznar" 2 => "C. Alvarez del Vayo Benito" 3 => "E. Jimenez Mesa" 4 => "K.P. Guzman Laura" 5 => "L. Fernández Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "360" "paginaFinal" => "366" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0230" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.N. Keers" 1 => "S.D. Williams" 2 => "J. Cooke" 3 => "D.M. Ashcroft" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40264-013-0090-2" "Revista" => array:6 [ "tituloSerie" => "Drug Saf" "fecha" => "2013" "volumen" => "36" "paginaInicial" => "1045" "paginaFinal" => "1067" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23975331" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0235" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Specialty-based, voluntary incident reporting in neonatal intensive care: description of 4846 incident reports" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "on behalf of the NEOSAFE study group" "etal" => false "autores" => array:6 [ 0 => "C. Snijders" 1 => "R.A. van Lingen" 2 => "H. Klip" 3 => "W.P.F. Fetter" 4 => "T.W. van der Schaaf" 5 => "H.A. Molendijk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2007.135020" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "2009" "volumen" => "94" "paginaInicial" => "F210" "paginaFinal" => "F215" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18838465" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0240" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Voluntary anonymous reporting of medical errors for neonatal intensive care" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Suresh" 1 => "J.D. Horbar" 2 => "P. Plsek" 3 => "J. Gray" 4 => "W.H. Edwards" 5 => "P.H. Shiono" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2004" "volumen" => "113" "paginaInicial" => "1609" "paginaFinal" => "1618" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15173481" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0245" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Errores medicos en pediatría y neonatología. Un nuevo enfoque disciplinar es necesario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Perez Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2006" "volumen" => "64" "paginaInicial" => "327" "paginaFinal" => "329" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0250" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Caminando hacia una cultura de seguridad en la unidad neonatal: experiencia de 6 años" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.T. Esqué Ruiz" 1 => "M.G. Moretones Suñol" 2 => "J.M. Rodríguez Miguélez" 3 => "S. Parés Tercero" 4 => "R. Cortés Albuixech" 5 => "E.M. Varón Ramírez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2015" "volumen" => "83" "paginaInicial" => "236" "paginaFinal" => "243" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0255" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional recommendations for the late-preterm infant after hospital discharge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Llapillone" 1 => "D.L. O’Connor" 2 => "D. Wang" 3 => "J. Rigo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpeds.2012.11.058" "Revista" => array:6 [ "tituloSerie" => "J Pediatr" "fecha" => "2013" "volumen" => "162" "paginaInicial" => "S90" "paginaFinal" => "S100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23445854" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0260" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Severity-indexed, incident report-based medication error-reporting program" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.C. Hartwig" 1 => "S.D. Denger" 2 => "P.J. Schneider" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Hosp Pharm" "fecha" => "1991" "volumen" => "48" "paginaInicial" => "2611" "paginaFinal" => "2616" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1814201" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0265" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focusing on preventability of adverse drug reactions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.T. Schumock" 1 => "J.P. Thornton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hosp Pharm" "fecha" => "1992" "volumen" => "27" "paginaInicial" => "538" "paginaFinal" => "542" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10118597" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0270" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measuring patient safety in neonatology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.K. Suresh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-0031-1286183" "Revista" => array:6 [ "tituloSerie" => "Am J Perinatol" "fecha" => "2012" "volumen" => "29" "paginaInicial" => "19" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21879457" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0275" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidents and errors in neonatal intensive care: a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Snijders" 1 => "R.A. van Lingen" 2 => "A. Molendijk" 3 => "W.P.F. Fetter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/adc.2006.106419" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "2007" "volumen" => "92" "paginaInicial" => "F391" "paginaFinal" => "F398" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17376782" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0280" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse events in the Neonatal Intensive Care Unit: development, testing, and findings of an NICU-Focused Trigger Tool to Identify Harm in North American NICUs" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.J. Sharek" 1 => "J.D. Horbar" 2 => "W. Mason" 3 => "H. Bisarya" 4 => "C.W. Thurm" 5 => "G. Suresh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2006-0565" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2006" "volumen" => "118" "paginaInicial" => "1332" "paginaFinal" => "1340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17015521" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0285" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The error in neonatal intensive care: a multicenter prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. De Franco" 1 => "S. Rizollo" 2 => "P. Angellotti" 3 => "A. Guala" 4 => "G. Stival" 5 => "F. Ferrero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Minerva Pediatr" "fecha" => "2014" "volumen" => "66" "paginaInicial" => "1" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24608576" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0290" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Iatrogenic events in admitted neonates: a prospective cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Ligi" 1 => "F. Arnaud" 2 => "E. Jouve" 3 => "S. Tardieu" 4 => "R. Sambuc" 5 => "U. 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Valls-i-Soler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "21" "paginaFinal" => "25" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0300" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and potential risk factors of drug-related problems in Hong Kong paediatric wards" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.N. Rashed" 1 => "L. Wilton" 2 => "C.H. Lo" 3 => "B.Y.S. Kwong" 4 => "S. Leung" 5 => "I.C.K. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Clin Pharmacol" "fecha" => "2013" "volumen" => "77" "paginaInicial" => "873" "paginaFinal" => "879" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24868576" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0305" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frequency of dosage prescribing medication errors associated with manual prescriptions for very preterm infants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Horri" 1 => "A. Cransac" 2 => "C. Quantin" 3 => "M. Abrahamowicz" 4 => "C. Ferdynus" 5 => "C. Sgro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jcpt.12194" "Revista" => array:6 [ "tituloSerie" => "J Clin Pharm Ther" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "637" "paginaFinal" => "641" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25060391" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0310" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validación en pediatría de un método para notificación y seguimiento de errores de medicación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.D. Guerrero-Aznar" 1 => "E. Jiménez-Mesa" 2 => "J. Cotrina-Luque" 3 => "A. Villalba-Moreno" 4 => "R. Cumplido-Corbacho" 5 => "L. Fernández-Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2014" "volumen" => "81" "paginaInicial" => "360" "paginaFinal" => "367" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0315" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NICU medication errors: identifying a risk profile for medication errors in the neonatal intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.A. Stavroudis" 1 => "A.D. Shore" 2 => "L. Morlock" 3 => "R.W. Hicks" 4 => "D. Bundy" 5 => "M.R. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/jp.2009.186" "Revista" => array:6 [ "tituloSerie" => "J Perinatol" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "459" "paginaFinal" => "468" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20043010" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0320" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Errores en la prescripción y transcripción de medicación de medicación en una unidad neonatal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Campino Vilegas" 1 => "López Herrera M.C." 2 => "M. García Franco" 3 => "I. López de Heredia Goya" 4 => "A. 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Franke" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pharmacotherapy" "fecha" => "2001" "volumen" => "21" "paginaInicial" => "1023" "paginaFinal" => "1036" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11560192" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0330" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Chedoe" 1 => "H. Molendijk" 2 => "W. Hospes" 3 => "E.R. van der Heuvel" 4 => "K. Taxis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/fetalneonatal-2011-300989" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "2012" "volumen" => "97" "paginaInicial" => "F449" "paginaFinal" => "F455" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22491014" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0335" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medication errors in pediatric inpatients: prevalence and results of a prevention program" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "and the Patient Safety Committee" "etal" => false "autores" => array:4 [ 0 => "P. Otero" 1 => "A. Leyton" 2 => "G. Mariani" 3 => "J.M. Ceriani Cernadas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2008-0014" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2008" "volumen" => "122" "paginaInicial" => "e737" "paginaFinal" => "e743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18762510" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0340" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of clinical pharmacist interventions in reducing paediatric prescribing errors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.M. Fernandez-Llamazares" 1 => "M.A. Calleja-Hernandez" 2 => "S. Manrique-Rodríguez" 3 => "C. Pérez-Sanz" 4 => "E. Duran-García" 5 => "M. Sanjurjo-Saez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/archdischild-2011-301239" "Revista" => array:6 [ "tituloSerie" => "Arch Dis Child" "fecha" => "2012" "volumen" => "97" "paginaInicial" => "564" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22362718" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0345" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of computerized physician order entry on clinical practice in a Newborn Intensive Care Unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Cordero" 1 => "L. Kuehn" 2 => "R.R. Kumar" 3 => "H.S. 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Medication errors in a neonatal unit: One of the main adverse events

Los errores de tratamiento en una unidad neonatal, uno de los principales acontecimientos adversos

M.T. Esqué Ruiz

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mtesque@gmail.com

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, M.G. Moretones Suñol, J.M. Rodríguez Miguélez, E. Sánchez Ortiz, M. Izco Urroz, M. de Lamo Camino, J. Figueras Aloy

Servicio Neonatología, ICGON, BCNatal, Hopital Clínic sede Maternitat, Universidad de Barcelona, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Neonatal units&#44; and especially the sections devoted to intensive care&#44; are among the hospital settings where treatment errors are most likely to occur&#46; Among the latter&#44; medication errors &#40;MEs&#41; are part of an emergent pathology that has received increasing attention from health professionals&#44; organisations and authorities in recent years&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a> as they constitute a serious health problem in hospitalised patients&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">2</span></a> and one that is underestimated in the paediatric and neonatal populations&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A ME is defined as any preventable event secondary to the misuse of a medication that may cause or lead to patient harm<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">4</span></a>&#59; on the other hand&#44; an <span class="elsevierStyleItalic">adverse drug event</span> &#40;ADE&#41; is defined as any harm&#44; severe or mild&#44; caused by the use &#40;or lack thereof&#41; of a drug&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">5</span></a> and an adverse drug reaction as a non-preventable response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis&#44; diagnosis&#44; or therapy of disease or for modification of physiological function&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It is estimated that MEs occur eight times more often in neonatal intensive care units &#40;NICUs&#41; than in adults in hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">8</span></a> The drug administration protocols in the neonatal period diverge from those applied in other age groups due to the lack of dosage forms fitting the needs of neonates&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">8&#44;9</span></a> their different physiology&#44; and the fact that they are a population of heterogeneous and changing individuals that require different regimens depending on their pathology&#44; weight&#44; gestational age and days of life&#46; Treating these patients requires measuring small volumes&#44; dividing unit doses into fractions and performing complex dilutions&#44; and the bioavailability after such manipulations is often unknown and unpredictable and may result in the use of toxic or ineffective doses&#46; This&#44; compounded by the variability in the pharmacokinetic and pharmacodynamic processes of the drugs &#40;preservatives&#44; stabilisers&#44; etc&#46;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">9</span></a> the greater severity of disease&#44; the longer length of stay and the impossibility of communicating with the patient among other factors make detecting errors more difficult&#46; In this regard&#44; Cotrina Luque et al&#46; have developed a model list of high-risk drugs in the neonatal and paediatric populations&#44; which they defined as those that may cause severe harm or even death when misused&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Medication errors can occur at different points in care delivery&#44; from the time of prescribing to the time of administration&#46; Although prescribing&#44; dispensing and administration are particularly important in the neonate&#44; the causes of errors<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a> often occur earlier &#40;labelling&#44; packaging&#44; names&#41;&#46; For all the above reasons&#44; the frequency with which they occur<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12&#44;13</span></a> and their potential seriousness&#44; the prevention of MEs must be addressed with a multidisciplinary approach&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">14</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">It is widely accepted that improving patient safety requires identifying and analysing errors and implementing the measures needed to prevent their reoccurrence&#46; The aim of our study was to analyse the MEs that occurred in a department of neonatology&#44; the medications involved&#44; the severity of the errors and the potential for preventing them&#44; and to describe the strategies implemented for their prevention&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">In the Department of Neonatology&#44; the Committee for Patient Safety &#40;Comisi&#243;n para la Seguridad del paciente neonatal &#91;CSPN&#93;&#41;&#44; which started to operate in 2008&#44; created a voluntary AE reporting system&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">15</span></a> As data were collected on the reported AEs&#44; they were analysed and preventive measures implemented&#46; To facilitate their study&#44; the AEs were entered into a Microsoft Office Access 2003 database and classified into events concerning patient identification&#44; diagnosis&#44; treatment &#40;due to medications or other therapies&#41;&#44; procedures &#40;diagnostic and therapeutic&#41; or equipment and devices&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Using the tools of the software application&#44; we selected the MEs based on the definition given in the introduction and classified them as prescribing or administration errors&#59; by the involved product &#40;drugs&#44; nutrition products&#44; parenteral nutrition products&#44; intravenous fluids&#44; blood products&#44; nitric oxide&#44; oxygen&#44; sucrose&#44; others&#41;&#59; the type of error &#40;incorrect dose&#44; delay in administration&#44; incorrect route or rate of administration&#44; medication or dose omission&#44; inappropriate&#44; deteriorated or expired medication&#44; etc&#46;&#41;&#59; the setting where the error took place &#40;intensive or intermediate care unit&#44; etc&#46;&#41;&#46; Due to the importance of nutrition for the adequate somatic and neurologic development of the preterm neonate&#44; nutrition products are considered as medication in this early stage of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">13&#44;16</span></a> With regard to the health care staff&#44; we collected data on the type of professional that made the report&#44; whether the reporter was directly involved or not in the AE&#44; and the reporter&#39;s seniority &#40;&#60;5 years&#44; 5&#8211;10 years&#44; &#62;10 years&#41;&#46; We analysed the contributing factors related to the health professionals &#40;distraction&#44; repetitiveness&#44; inadequate training&#44; personal factors&#44; communication problems&#41;&#44; organisational factors &#40;excessive workloads&#44; lack of protocols&#44; infrastructure&#44; environmental factors&#44; human resources&#44; other causes&#41; and factors related to equipment and devices&#46; We assessed the impact on the patient according to the scale developed by Hartwig et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">17</span></a> We classified the measures that were adopted to correct these errors into three categories&#58; simple &#40;direct notification&#44; safety alerts&#44; correct labelling&#44; use of posters&#44; checking equipment and materials&#44; etc&#46;&#41;&#44; intermediate &#40;protocols&#44; monthly bulletin&#44; clinical sessions&#44; courses&#44; etc&#46;&#41; and high-level &#40;manuals&#44; root cause analyses&#44; annual conferences&#44; prospective studies&#44; round tables&#44; etc&#46;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In the analysis of MEs&#44; we studied whether they had been intercepted&#44; that is&#44; whether they had been detected before reaching patients&#44; and whether they were preventable&#46; We also analysed preventability&#44; retrospectively applying an adaptation to neonatology of the table proposed by Otero-L&#243;pez et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">2</span></a> which in turn was an adaptation of the questionnaire developed by Schumock and Thornton&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">18</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">We analysed the AEs reported between February 1&#44; 2008 and January 31&#44; 2015&#46; We classified the 4575 newborns admitted to the neonatology department for a total of 73&#44;840 patient days during this seven-year period based on whether they stayed in the intensive care unit &#40;2212 patients admitted for 13&#44;579 patient days&#41; or the intermediate care unit &#40;4575 patients admitted for 60&#44;261 days&#41;&#46; Of the 1628 reported AEs&#44; 511 &#40;31&#46;4&#37;&#41; were MEs &#40;6 MEs per month under study&#41;&#46; The incidence of MEs reported in the intensive care unit was 32&#46;2 per 1000 patient days &#40;19&#46;7 MEs per 100 admitted newborns&#41;&#46; Of all the MEs we identified&#44; 39&#46;5&#37; were prescribing errors and 68&#46;1&#37; administration errors&#44; while 3 events &#40;0&#46;6&#37;&#41; were finally classified as ADRs &#40;unpreventable&#41; as opposed to MEs&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> presents the characteristics of the errors&#58; product involved&#44; type of error&#44; setting of error&#44; seniority of involved professional&#44; type of professional that made the report&#44; and whether the error was intercepted&#46; It is worth noting that 65&#46;4&#37; of MEs involved drugs&#44; most frequently antibiotics &#40;86 MEs&#41;&#44; and gentamicin &#40;29 MEs&#41; and vancomycin &#40;17 MEs&#41; in particular&#44; with most errors consisting of wrong dosing frequency&#46; Thirty-four reports involved sedation and analgesia &#40;the product involved in 26 was fentanyl&#41;&#46; Other involved drugs were caffeine &#40;22 MEs&#41;&#44; diuretics &#40;18 MEs&#41;&#44; eye drops &#40;14 MEs&#41;&#44; inotropes &#40;12 MEs&#41;&#44; insulin &#40;12 MEs&#41; and indometacin &#40;6 MEs&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">When it came to the type of error&#44; the most frequent was incorrect dosing &#40;33&#46;1&#37;&#41;&#46; The errors were intercepted in 17&#37; of cases&#46; Most MEs occurred in the intensive care unit &#40;72&#37;&#41;&#46; The group of professionals for which errors were least frequently reported was the group with 5&#8211;10 years of seniority &#40;21&#46;6&#37;&#41;&#46; Nursing staff made 69&#46;5&#37; of the reports&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> summarises the impact on the patient according to the severity-index scale developed by Hartwig et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">17</span></a> Of all errors&#44; 10&#46;6&#37; harmed the patient &#40;8&#46;32 MEs per 1000 patient days&#41;&#44; and 0&#46;6&#37; &#40;0&#46;22 per 1000 days&#41; may have contributed to the development of permanent sequelae or death &#40;severity levels 5&#8211;6&#41;&#46; The possible causes for MEs are summarised in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Factors related to the health care professional were documented in 89&#37; of the reports&#44; with distraction being the most frequent cause &#40;59&#37;&#41;&#46; Of the errors related to organisational factors &#40;18&#46;8&#37;&#41;&#44; most were due to excessive workloads &#40;8&#46;6&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">We considered 99&#46;4&#37; of MEs preventable after reviewing them using the table adapted from Otero-L&#243;pez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">2</span></a><a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> presents the results of this analysis&#46; The only events that could not be classified in this table were the three identified as ADRs&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The strategies implemented for the prevention of MEs included 205 simple measures &#40;alerts&#44; recommendations&#41; and 299 intermediate measures &#40;protocols&#44; clinical sessions&#44; courses&#44; etc&#46;&#41;&#44; and the high-level strategies included four root cause analyses and the production of a monograph on the administration of intravenous drugs in the newborn&#44; written by a group of nurses in the unit and made available in laminated format for consultation in the department and in pocket format for its distribution to every staff member&#46; Due to the inherent characteristics of the ME identification system&#44; it is not possible to assess the impact of these actions on the reduction of MEs&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0075" class="elsevierStylePara elsevierViewall">Comparisons between studies are difficult due to the differences in the data collection methods and definitions used in each of them&#46; According to Suresh&#44; the number of AEs that are detected and documented depends on the strategies implemented for their identification&#44; and considering the variability in the approaches of different studies&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">19</span></a> comparisons with other studies would be less pressing than finding the errors that occur in house and for prevention strategies to be accepted&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In the analysis by Snijders et al&#46;&#44; of 4846 voluntary incident reports corresponding to 3859 admissions&#44; 27&#37; were medication errors&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">12</span></a> a figure similar to the one found in our study &#40;32&#46;2&#37;&#41;&#46; The rate of MEs is much higher in studies in which voluntary reporting is used compared to studies that use data from mandatory reporting systems &#40;13&#8211;14&#46;7 versus 0&#46;97 per 1000 patients&#47;day in the NICU&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">20</span></a> This could be explained by the fact that mandatory reporting focuses on errors that produce permanent harm or death while voluntary reporting includes near-misses and low-severity events&#44; and when trigger tools are used to investigate the circumstances that may cause AEs&#44; the number of reports is much higher than that obtained through mandatory reporting&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">21</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Suresh et al&#46; found that MEs &#40;including errors involving nutrition and blood products&#41; are the most frequent cause of AEs &#40;47&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">13</span></a> Extremely preterm newborns require optimal nutritional support for adequate development&#44; be it fortified human milk or special formulas&#44; so nutrition products are considered medication<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">16</span></a> and errors involving them MEs&#46; A recent study by De Franco et al&#46; described a rate of errors of 43 per 100 patients in the NICU&#44; 48&#37; of which were administration errors&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">22</span></a> Ligi et al&#46; reported an incidence of 4&#46;9 MEs per 100 admissions&#46; The most frequent errors were administration errors&#44; almost all of which were programming mistakes of pumps&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> Campino et al&#46; analysed 91 medication samples&#44; 52 of vancomycin and 39 of tobramycin&#44; and detected calculation mistakes in 4&#46;6&#37; of the samples and precision errors in 37&#46;9&#37;&#46; The authors concluded that while the detected errors had not resulted in evident harm to the patient&#44; they had the potential to cause severe complications&#44; and underscored the urgency of improving the methods used to prepare intravenous medications at the bedside&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">24</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In our study&#44; administration errors &#40;68&#46;1&#37;&#41; were also more frequent than prescribing errors &#40;39&#46;5&#37;&#41;&#44; and incorrect dosing was the most frequent error in both categories &#40;51&#46;5&#37;&#41;&#44; a finding consistent with the results of a study conducted in Hong Kong paediatric wards by Rashed et al&#46; &#40;42&#46;7&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">25</span></a> Horri et al&#46; found a rate of dosing errors of 3&#46;8 and 3&#46;1 per 100 manual prescriptions for preterm newborns less than 33 weeks&#8217; gestational age in two NICUs&#44; and concluded that manual prescriptions should be forbidden in neonatal units&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">26</span></a> In our study&#44; 32&#46;2&#37; of prescribing errors were intercepted&#44; a low percentage compared to the one found in the study by De Franco et al&#46;&#44; in which 63&#37; were intercepted&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">22</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Seventy-two percent of the reported MEs took place in the NICU&#44; which was expected on account of the polymedication of patients in this unit&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Nurses reported errors twice as frequently as physicians &#40;69&#46;5&#37; compared to 30&#46;4&#37;&#41;&#46; Guerrero-Aznar et al&#46; found that nurses reported errors 11 times as frequently as physicians&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">27</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Neither the seniority or the inexperience of health care professionals were protective factors associated with fewer errors&#59; on the contrary&#44; the group reported to make the least errors corresponded to professionals with 5&#8211;10 years of seniority &#40;21&#46;6&#37;&#41;&#46; In an analysis of 6749 MEs&#44; Stavroudis et al&#46; identified human factors as the most frequent cause of errors &#40;68&#46;4&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">28</span></a> while in our study&#44; we found that factors related to health care professionals were noted in 90&#37; of the reports&#44; and organisational factors in 18&#46;8&#37; of reports&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Fortunately&#44; a high percentage of MEs did not lead to harm &#40;89&#46;4&#37;&#41;&#44; but we must succeed in reducing these too&#44; as failing to do so is indicative of low-quality care&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a> There is evidence that AEs result from a combination of deficiencies in the system and errors made by professionals&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">29</span></a> Analysing potential MEs is useful because it allows the identification of break points in the system as well as points where the system works&#44; which can help intercept errors&#46; It is widely accepted that 1&#37;&#8211;5&#37; of MEs may cause harm to the patient&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">30</span></a> so barriers must be set up to prevent their occurrence&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Multiple measures have been undertaken to reduce MEs&#44; the most salient being the production of a monograph on the administration of intravenous drugs in newborns written by a group of nurses that work in the unit that were not members of the CSPN but were pursuing the same goals&#46; Comparing the present and past outcomes of our institution is difficult&#44; because as the safety culture grows&#44; the number of voluntary reports increases&#44; masking the progressive improvement&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The currently used strategies of the &#8220;six rights&#8221; &#40;right individual&#44; right medication&#44; right dose&#44; right time&#44; right route&#44; right documentation&#41; and the &#8220;four I&#39;s&#8221; &#40;I prepare&#44; I administer&#44; I document&#44; I am responsible&#41; are considered insufficient to succeed in reducing the incidence of MEs&#44; as this not only requires <span class="elsevierStyleItalic">safe</span> medications and procedures&#44; but also the creation of <span class="elsevierStyleItalic">fail-safe</span> systems with integrated safety measures and devices that can reduce errors to the maximum or ensure that they do not reach the patient&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;19</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">The strategies to prevent MEs must include the development and use of protocols&#44; staff training&#44; and the involvement of the health authorities&#44; medicine regulatory agencies&#44; and pharmaceutical companies&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">1</span></a> Drug formulations adapted to neonates&#44; the preparation of unit doses&#44; the specificity of routes of administration&#44; the use of automated systems and digital identification&#44; electronic prescription&#44; a broad training programme&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">31&#44;32</span></a> continuous monitoring of AEs<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> and having a hospital pharmacist on staff<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">31&#44;33</span></a> contribute effectively to reducing MEs in the paediatric population and especially in the neonatal subset&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The high technological complexity of neonatal care requires up-to-date knowledge and the protocolisation&#44; assessment and analysis of the work performed&#46; The detection of errors must not lead to assigning blame&#44; but to their analysis and correction&#44; improving communication between professionals and promoting better practices&#46; We need not only create a safety culture&#44; which refers to the values it is founded on&#44; but also a safety climate&#44; focused on the concepts of productiveness and efficacy&#44; and with particular emphasis on the prevention of MEs&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">19&#44;35</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interests</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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          "clase" => "keyword"
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            0 => "Treatment errors"
            1 => "Medication errors"
            2 => "Prescription errors"
            3 => "Administration errors"
            4 => "Culture of safety"
            5 => "Newborn"
            6 => "Adverse events"
            7 => "Prevention"
            8 => "Critical incident reporting"
            9 => "Drug safety"
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          "clase" => "keyword"
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          "palabras" => array:10 [
            0 => "Errores de tratamiento"
            1 => "Errores de medicaci&#243;n"
            2 => "Errores de prescripci&#243;n"
            3 => "Errores de administraci&#243;n"
            4 => "Cultura de seguridad"
            5 => "Reci&#233;n nacido"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Neonatal units are one of the hospital areas most exposed to committing treatment errors&#46; A medication error &#40;ME&#41; is defined as the avoidable incident secondary to drug misuse that causes or may cause harm to the patient&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this paper is to present the incidence of ME &#40;including feeding&#41; reported in our neonatal unit and its characteristics and possible causal factors&#46; A list of the strategies implemented for prevention is presented&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">An analysis was performed on the ME declared in a neonatal unit&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 511 MEs were reported over a period of seven years in the neonatal unit&#46; The incidence in the critical care unit was 32&#46;2 per 1000 hospital days or 20 per 100 patients&#44; of which 0&#46;22 per 1000 days had serious repercussions&#46; The MEs reported were&#44; 39&#46;5&#37; prescribing errors&#44; 68&#46;1&#37; administration errors&#44; 0&#46;6&#37; were adverse drug reactions&#46; Around two-thirds &#40;65&#46;4&#37;&#41; were produced by drugs&#44; with 17&#37; being intercepted&#46; The large majority &#40;89&#46;4&#37;&#41; had no impact on the patient&#44; but 0&#46;6&#37; caused permanent damage or death&#46; Nurses reported 65&#46;4&#37; of MEs&#46; The most commonly implicated causal factor was distraction &#40;59&#37;&#41;&#46; Simple corrective action &#40;alerts&#41;&#44; and intermediate &#40;protocols&#44; clinical sessions and courses&#41; and complex actions &#40;causal analysis&#44; monograph&#41; were performed&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">It is essential to determine the current state of ME&#44; in order to establish preventive measures and&#44; together with teamwork and good practices&#44; promote a climate of safety&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
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          2 => array:2 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las unidades neonatales son uno de los &#225;mbitos hospitalarios m&#225;s expuestos a la comisi&#243;n de errores de tratamiento&#46; El error de medicaci&#243;n &#40;EM&#41; se define como el incidente&#44; evitable&#44; secundario a la utilizaci&#243;n inapropiada de medicamentos&#44; que causa o puede causar da&#241;o al paciente&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este trabajo es dar a conocer la incidencia de EM &#40;incluida la alimentaci&#243;n&#41; notificados en nuestra unidad neonatal as&#237; como sus caracter&#237;sticas y posibles factores causales&#46; As&#237; mismo se expone una relaci&#243;n de las estrategias llevadas a cabo para su prevenci&#243;n&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se analizan los EM declarados en un servicio de neonatolog&#237;a&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Durante un per&#237;odo de 7 a&#241;os&#44; en el servicio de neonatolog&#237;a se han notificado 511 EM&#46; La incidencia en la unidad de cr&#237;ticos fue de 32&#44;2 por 1&#46;000 d&#237;as de hospitalizaci&#243;n o 0&#44;2 por paciente&#44; de los cuales 0&#44;22 por 1&#46;000 d&#237;as tuvieron repercusi&#243;n grave&#59; el 39&#44;5&#37; fueron errores de prescripci&#243;n&#44; el 68&#44;1&#37; de administraci&#243;n y el 0&#44;6&#37; reacciones adversas a medicamentos&#46; El 65&#44;4&#37; fue producido por f&#225;rmacos&#46; Se intercept&#243; el 17&#37;&#46; El 89&#44;4&#37; no tuvo repercusi&#243;n sobre el paciente&#59; el 0&#44;6&#37; caus&#243; secuelas permanentes o muerte&#46; Los profesionales de enfermer&#237;a declararon el 65&#44;4&#37; de los EM&#46; El factor causal m&#225;s frecuentemente implicado fue la distracci&#243;n &#40;59&#37;&#41;&#46; Se realizaron medidas correctoras simples &#40;alertas&#41;&#44; intermedias &#40;protocolos&#44; sesiones cl&#237;nicas&#44; cursos&#41; y complejas &#40;an&#225;lisis causales&#44; monograf&#237;a&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Es imprescindible conocer la propia realidad para poder establecer medidas preventivas y&#44; junto al trabajo en equipo y las buenas pr&#225;cticas&#44; promover un clima de seguridad&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as&#58; Esqu&#233; Ruiz MT&#44; Moretones Su&#241;ol MG&#44; Rodr&#237;guez Migu&#233;lez JM&#44; S&#225;nchez Ortiz E&#44; Izco Urroz M&#44; de Lamo Camino M&#44; et al&#46; Los errores de tratamiento en una unidad neonatal&#44; uno de los principales acontecimientos adversos&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;84&#58;211&#8211;217&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Prescription<br>202 &#40;39&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Administration<br>348 &#40;68&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>511&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">By product</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">160 &#40;79&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">208 &#40;59&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">334 &#40;65&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nutrition product&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;5&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48 &#40;13&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;12&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Parenteral nutrition product&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;12&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;9&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>IV fluids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;9&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Blood products&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;3&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;3&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>iNO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oxygen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;0&#46;86&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">By type of error</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Delay in administration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;8&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;16&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;14&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Incorrect route&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;2&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;3&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;3&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Incorrect rate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46 &#40;13&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;10&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Medication or dose omission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41 &#40;20&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;20&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;20&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Incorrect medication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;8&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Deteriorated or expired medication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;2&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;2&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Incorrect dose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">104 &#40;51&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;32&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">169 &#40;33&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Illegible prescription&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;4&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;2&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;2&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other causes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">By the setting where error was made</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intensive care unit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">140 &#40;69&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">262 &#40;75&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">368 &#40;72&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intermediate care unit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;28&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77 &#40;22&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">129 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;4&#46;02&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;4&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Seniority of professional</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#60;5 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;30&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;26&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">139 &#40;32&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>5&#8211;10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;15&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;21&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;21&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62;10 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83 &#40;41&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">126 &#40;36&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">195 &#40;45&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not documented&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;12&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56 &#40;16&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">85 &#40;16&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Reported by</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Physician&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59 &#40;29&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;20&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">121 &#40;30&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nurse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">103 &#40;51&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">183 &#40;52&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">277 &#40;69&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not documented&#47;other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;19&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93 &#40;26&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">113 &#40;22&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intercepted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;32&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;6&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;17&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Source</span>&#58; Hartwig et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">17</span></a></p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Impact of medication errors on patient outcomes<br><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>511</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">No harm&#58; 457 &#40;89&#46;4&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">The error did not reach the patient&#46; Intercepted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">The error reached the patient but caused no harm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">272&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">The error resulted in the need for increased monitoring of the patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Harm&#58; 54 &#40;10&#46;6&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Change in vital signs or need for additional blood draws for laboratory monitoring&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Error requiring treatment with another medication or that increased the length of stay&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Error that resulted in permanent harm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Error that contributed to the death of the patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1023027.png"
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">In one case&#44; delay in the assessment of a newborn with a blood culture positive for <span class="elsevierStyleItalic">Escherichia coli</span>&#46; Severe hypercalcaemia due to excessive calcium supplementation in preterm newborn with a weight of 700<span class="elsevierStyleHsp" style=""></span>g and 25 weeks&#8217; gestational age&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Impact of medication errors on patient outcomes based on the Hartwig scale&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Staff-related factors</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">460 &#40;90&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Distraction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">306 &#40;59&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Training&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">98 &#40;19&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Personal factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91 &#40;17&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Communication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;9&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Repetitive work&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68 &#40;13&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Team work&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47 &#40;9&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patient information&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;0&#46;98&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fatigue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;0&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Organisational factors</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96 &#40;18&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Excessive workload&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;8&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lack of protocols&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;2&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infrastructure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;4&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Environmental factors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;1&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Human resources&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;1&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other causes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;1&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Factors related to equipment&#44; devices&#44; etc&#46;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Factors related to the patient</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;0&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Factors related to medications</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Some errors involved different causal factors&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Causes associated with the medication errors &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>511&#41;&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Adapted from Schumock and Thornton&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">1&#44;18</span></a></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">A MRAE is considered potentially preventable when one or more of the following questions can be answered in the affirmative&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total number of affirmative answers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the drug involved in the MRAE not considered appropriate for the patient&#39;s clinical condition&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the dose&#44; route&#44; and frequency of administration not appropriate for the patient&#39;s age&#44; weight or underlying disease&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">268&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the duration of treatment longer or shorter than the one established for the indication for which the drug was prescribed&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Were the clinical tests required for monitoring treatment not performed&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the patient have a previous history of allergic reaction or a similar adverse reaction to the same medication or to a medication with which it is cross-reactive or that have the same mechanism of action&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE occur as a result from some type of interaction&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Were potentially toxic serum concentrations of the drug or other abnormal results detected in the laboratory tests performed for therapeutic drug monitoring&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Was the preventive treatment required to prevent the adverse reaction not performed when the patient met the criteria to receive it&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from poor compliance with the prescription&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from an error in the administration of the drug&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Did the MRAE result from a circumstance that could be considered an error&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Criteria used to classify medication-related adverse events &#40;MRAEs&#41; according to their preventability&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:35 [
            0 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acontecimientos adversos por medicamentos&#58; una patolog&#237;a emergente"
                      "autores" => array:1 [
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                            0 => "M&#46;J&#46; Otero"
                            1 => "A&#46; Dom&#237;nguez-Gil"
                          ]
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Farm Hosp"
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                        "volumen" => "24"
                        "paginaInicial" => "258"
                        "paginaFinal" => "266"
                      ]
                    ]
                  ]
                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acontecimientos adversos prevenibles causados por medicamentos en pacientes hospitalizados"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Otero-L&#243;pez"
                            1 => "P&#46; Alonso-Hern&#225;ndez"
                            2 => "J&#46;A&#46; Maderuelo-Fern&#225;ndez"
                            3 => "B&#46; Garrido-Corro"
                            4 => "A&#46; Dominguez-Gil"
                            5 => "A&#46; S&#225;nchez-Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
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                        "paginaInicial" => "81"
                        "paginaFinal" => "87"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0190"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nature of medication errors in neonatal intensive care with strategies to improve safety&#46; A review of the current literature"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Chedoe"
                            1 => "A&#46; Harry"
                            2 => "H&#46; Molendijk"
                            3 => "T&#46;A&#46;M&#46; Dittrich"
                            4 => "F&#46;G&#46;A&#46; Jansman"
                            5 => "J&#46;W&#46; Harting"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Saf"
                        "fecha" => "2007"
                        "volumen" => "30"
                        "paginaInicial" => "503"
                        "paginaFinal" => "516"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17536876"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "NCCMERP taxonomy of medications errors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "National Coordinating Council for Medication Error Reporting and Prevention"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:1 [
                        "fecha" => "1998"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breakthrough series guide&#58; reducing adverse drug events"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;L&#46; Leape"
                            1 => "A&#46; Kabcenell"
                            2 => "D&#46;M&#46; Berwick"
                            3 => "J&#46; Roessner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1998"
                        "editorial" => "Institute for Healthcare Improvement"
                        "editorialLocalizacion" => "Boston"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Requirements for adverse reaction reporting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1975"
                        "editorial" => "World Health Organization"
                        "editorialLocalizacion" => "Geneva"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Errores de medicaci&#243;n&#58; estandarizaci&#243;n de la terminolog&#237;a y clasificaci&#243;n&#46; Resultados de la Beca Ruiz-Jarabo 2000"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;J&#46; Otero-L&#243;pez"
                            1 => "C&#46; Codina Jan&#233;"
                            2 => "M&#46;J&#46; Tam&#233;s Alonso"
                            3 => "M&#46; P&#233;rez Encinas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Farm Hosp"
                        "fecha" => "2003"
                        "volumen" => "27"
                        "paginaInicial" => "137"
                        "paginaFinal" => "149"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12835826"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medication errors in the neonatal intensive care unit&#58; special patients&#44; unique issues"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;E&#46; Gray"
                            1 => "D&#46;A&#46; Goldmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/adc.2003.046060"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2004"
                        "volumen" => "89"
                        "paginaInicial" => "F472"
                        "paginaFinal" => "F473"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15499131"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#191;Tienen los reci&#233;n nacidos las mismas oportunidades farmacoterap&#233;uticas que los adultos&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Campino Villegas"
                            1 => "M&#46;C&#46; L&#243;pez Herrera"
                            2 => "M&#46;I&#46; Caballero"
                            3 => "M&#46; Garc&#237;a Franco"
                            4 => "I&#46; L&#243;pez de Heredia y Goya"
                            5 => "A&#46; Valls i Soler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "64"
                        "paginaInicial" => "428"
                        "paginaFinal" => "432"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lista modelo de medicamentos de alto riesgo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Cotrina Luque"
                            1 => "M&#46;D&#46; Guerrero Aznar"
                            2 => "C&#46; Alvarez del Vayo Benito"
                            3 => "E&#46; Jimenez Mesa"
                            4 => "K&#46;P&#46; Guzman Laura"
                            5 => "L&#46; Fern&#225;ndez Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2013"
                        "volumen" => "79"
                        "paginaInicial" => "360"
                        "paginaFinal" => "366"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes of medication administration errors in hospitals&#58; a systematic review of quantitative and qualitative evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;N&#46; Keers"
                            1 => "S&#46;D&#46; Williams"
                            2 => "J&#46; Cooke"
                            3 => "D&#46;M&#46; Ashcroft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40264-013-0090-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Saf"
                        "fecha" => "2013"
                        "volumen" => "36"
                        "paginaInicial" => "1045"
                        "paginaFinal" => "1067"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23975331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Specialty-based&#44; voluntary incident reporting in neonatal intensive care&#58; description of 4846 incident reports"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the NEOSAFE study group"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Snijders"
                            1 => "R&#46;A&#46; van Lingen"
                            2 => "H&#46; Klip"
                            3 => "W&#46;P&#46;F&#46; Fetter"
                            4 => "T&#46;W&#46; van der Schaaf"
                            5 => "H&#46;A&#46; Molendijk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/adc.2007.135020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2009"
                        "volumen" => "94"
                        "paginaInicial" => "F210"
                        "paginaFinal" => "F215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18838465"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Voluntary anonymous reporting of medical errors for neonatal intensive care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Suresh"
                            1 => "J&#46;D&#46; Horbar"
                            2 => "P&#46; Plsek"
                            3 => "J&#46; Gray"
                            4 => "W&#46;H&#46; Edwards"
                            5 => "P&#46;H&#46; Shiono"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2004"
                        "volumen" => "113"
                        "paginaInicial" => "1609"
                        "paginaFinal" => "1618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15173481"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Errores medicos en pediatr&#237;a y neonatolog&#237;a&#46; Un nuevo enfoque disciplinar es necesario"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Perez Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "64"
                        "paginaInicial" => "327"
                        "paginaFinal" => "329"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0250"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caminando hacia una cultura de seguridad en la unidad neonatal&#58; experiencia de 6 a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;T&#46; Esqu&#233; Ruiz"
                            1 => "M&#46;G&#46; Moretones Su&#241;ol"
                            2 => "J&#46;M&#46; Rodr&#237;guez Migu&#233;lez"
                            3 => "S&#46; Par&#233;s Tercero"
                            4 => "R&#46; Cort&#233;s Albuixech"
                            5 => "E&#46;M&#46; Var&#243;n Ram&#237;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2015"
                        "volumen" => "83"
                        "paginaInicial" => "236"
                        "paginaFinal" => "243"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutritional recommendations for the late-preterm infant after hospital discharge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Llapillone"
                            1 => "D&#46;L&#46; O&#8217;Connor"
                            2 => "D&#46; Wang"
                            3 => "J&#46; Rigo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2012.11.058"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2013"
                        "volumen" => "162"
                        "paginaInicial" => "S90"
                        "paginaFinal" => "S100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23445854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severity-indexed&#44; incident report-based medication error-reporting program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;C&#46; Hartwig"
                            1 => "S&#46;D&#46; Denger"
                            2 => "P&#46;J&#46; Schneider"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Hosp Pharm"
                        "fecha" => "1991"
                        "volumen" => "48"
                        "paginaInicial" => "2611"
                        "paginaFinal" => "2616"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1814201"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Focusing on preventability of adverse drug reactions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;T&#46; Schumock"
                            1 => "J&#46;P&#46; Thornton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hosp Pharm"
                        "fecha" => "1992"
                        "volumen" => "27"
                        "paginaInicial" => "538"
                        "paginaFinal" => "542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10118597"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring patient safety in neonatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;K&#46; Suresh"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0031-1286183"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Perinatol"
                        "fecha" => "2012"
                        "volumen" => "29"
                        "paginaInicial" => "19"
                        "paginaFinal" => "26"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21879457"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0275"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidents and errors in neonatal intensive care&#58; a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Snijders"
                            1 => "R&#46;A&#46; van Lingen"
                            2 => "A&#46; Molendijk"
                            3 => "W&#46;P&#46;F&#46; Fetter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/adc.2006.106419"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2007"
                        "volumen" => "92"
                        "paginaInicial" => "F391"
                        "paginaFinal" => "F398"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17376782"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "21"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adverse events in the Neonatal Intensive Care Unit&#58; development&#44; testing&#44; and findings of an NICU-Focused Trigger Tool to Identify Harm in North American NICUs"
                      "autores" => array:1 [
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                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                        "link" => array:1 [
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                            3 => "S&#46; Tardieu"
                            4 => "R&#46; Sambuc"
                            5 => "U&#46; Simeoni"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2008"
                        "volumen" => "371"
                        "paginaInicial" => "404"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18242414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                      "autores" => array:1 [
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                          "autores" => array:5 [
                            0 => "A&#46; Campino"
                            1 => "E&#46; Santesteban"
                            2 => "M&#46; Garc&#237;a"
                            3 => "M&#46; Rueda"
                            4 => "A&#46; Valls-i-Soler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2013"
                        "volumen" => "79"
                        "paginaInicial" => "21"
                        "paginaFinal" => "25"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0300"
              "etiqueta" => "25"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and potential risk factors of drug-related problems in Hong Kong paediatric wards"
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;N&#46; Rashed"
                            1 => "L&#46; Wilton"
                            2 => "C&#46;H&#46; Lo"
                            3 => "B&#46;Y&#46;S&#46; Kwong"
                            4 => "S&#46; Leung"
                            5 => "I&#46;C&#46;K&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Clin Pharmacol"
                        "fecha" => "2013"
                        "volumen" => "77"
                        "paginaInicial" => "873"
                        "paginaFinal" => "879"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24868576"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
                      "titulo" => "Frequency of dosage prescribing medication errors associated with manual prescriptions for very preterm infants"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Horri"
                            1 => "A&#46; Cransac"
                            2 => "C&#46; Quantin"
                            3 => "M&#46; Abrahamowicz"
                            4 => "C&#46; Ferdynus"
                            5 => "C&#46; Sgro"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jcpt.12194"
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                        "tituloSerie" => "J Clin Pharm Ther"
                        "fecha" => "2014"
                        "volumen" => "39"
                        "paginaInicial" => "637"
                        "paginaFinal" => "641"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25060391"
                            "web" => "Medline"
                          ]
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                ]
              ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validaci&#243;n en pediatr&#237;a de un m&#233;todo para notificaci&#243;n y seguimiento de errores de medicaci&#243;n"
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                            0 => "M&#46;D&#46; Guerrero-Aznar"
                            1 => "E&#46; Jim&#233;nez-Mesa"
                            2 => "J&#46; Cotrina-Luque"
                            3 => "A&#46; Villalba-Moreno"
                            4 => "R&#46; Cumplido-Corbacho"
                            5 => "L&#46; Fern&#225;ndez-Fern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
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                        "volumen" => "81"
                        "paginaInicial" => "360"
                        "paginaFinal" => "367"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "NICU medication errors&#58; identifying a risk profile for medication errors in the neonatal intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;A&#46; Stavroudis"
                            1 => "A&#46;D&#46; Shore"
                            2 => "L&#46; Morlock"
                            3 => "R&#46;W&#46; Hicks"
                            4 => "D&#46; Bundy"
                            5 => "M&#46;R&#46; Miller"
                          ]
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:2 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "J Perinatol"
                        "fecha" => "2010"
                        "volumen" => "30"
                        "paginaInicial" => "459"
                        "paginaFinal" => "468"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20043010"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                          "etal" => false
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                            0 => "A&#46; Campino Vilegas"
                            1 => "L&#243;pez Herrera M&#46;C&#46;"
                            2 => "M&#46; Garc&#237;a Franco"
                            3 => "I&#46; L&#243;pez de Heredia Goya"
                            4 => "A&#46; Valls I Soler"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
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                        "volumen" => "64"
                        "paginaInicial" => "330"
                        "paginaFinal" => "335"
                      ]
                    ]
                  ]
                ]
              ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medication errors in the United States hospitals"
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                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Bond"
                            1 => "C&#46;L&#46; Raehl"
                            2 => "T&#46; Franke"
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                        "paginaInicial" => "1023"
                        "paginaFinal" => "1036"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11560192"
                            "web" => "Medline"
                          ]
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                  ]
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                      "titulo" => "The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care"
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                          "etal" => false
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                            2 => "W&#46; Hospes"
                            3 => "E&#46;R&#46; van der Heuvel"
                            4 => "K&#46; Taxis"
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                      "doi" => "10.1136/fetalneonatal-2011-300989"
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                        "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed"
                        "fecha" => "2012"
                        "volumen" => "97"
                        "paginaInicial" => "F449"
                        "paginaFinal" => "F455"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22491014"
                            "web" => "Medline"
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                      "titulo" => "Medication errors in pediatric inpatients&#58; prevalence and results of a prevention program"
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                          "colaboracion" => "and the Patient Safety Committee"
                          "etal" => false
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                        "volumen" => "122"
                        "paginaInicial" => "e737"
                        "paginaFinal" => "e743"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18762510"
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                      "titulo" => "Impact of clinical pharmacist interventions in reducing paediatric prescribing errors"
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Article information

ISSN: 23412879
Original language: English

DOI:10.1016/j.anpede.2015.09.036

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Year/Month	Html	Pdf	Total

2024 October	89	38	127
2024 September	54	43	97
2024 August	75	70	145
2024 July	77	37	114
2024 June	101	25	126
2024 May	74	38	112
2024 April	80	39	119
2024 March	94	25	119
2024 February	67	29	96
2024 January	70	28	98
2023 December	72	22	94
2023 November	88	21	109
2023 October	83	30	113
2023 September	82	27	109
2023 August	64	18	82
2023 July	81	35	116
2023 June	60	32	92
2023 May	105	25	130
2023 April	54	16	70
2023 March	73	25	98
2023 February	70	33	103
2023 January	52	26	78
2022 December	86	20	106
2022 November	80	47	127
2022 October	94	53	147
2022 September	81	25	106
2022 August	105	47	152
2022 July	71	39	110
2022 June	46	28	74
2022 May	67	35	102
2022 April	80	42	122
2022 March	90	51	141
2022 February	87	58	145
2022 January	98	36	134
2021 December	77	44	121
2021 November	106	83	189
2021 October	111	69	180
2021 September	57	55	112
2021 August	56	37	93
2021 July	76	27	103
2021 June	106	33	139
2021 May	146	41	187
2021 April	277	112	389
2021 March	131	65	196
2021 February	101	62	163
2021 January	89	37	126
2020 December	87	40	127
2020 November	133	40	173
2020 October	226	39	265
2020 September	164	54	218
2020 August	145	25	170
2020 July	147	22	169
2020 June	168	23	191
2020 May	116	35	151
2020 April	50	30	80
2020 March	47	31	78
2020 February	67	34	101
2020 January	50	26	76
2019 December	96	22	118
2019 November	66	21	87
2019 October	89	43	132
2019 September	95	30	125
2019 August	118	39	157
2019 July	61	40	101
2019 June	66	25	91
2019 May	108	42	150
2019 April	127	61	188
2019 March	73	30	103
2019 February	72	25	97
2019 January	81	31	112
2018 December	105	30	135
2018 November	176	54	230
2018 October	226	34	260
2018 September	92	18	110
2018 July	0	1	1
2018 June	4	0	4
2018 May	6	0	6
2018 April	28	0	28
2018 March	51	0	51
2018 February	33	0	33
2018 January	41	0	41
2017 December	20	0	20
2017 November	26	0	26
2017 October	41	0	41
2017 September	29	0	29
2017 August	23	0	23
2017 July	25	1	26
2017 June	34	15	49
2017 May	38	13	51
2017 April	25	6	31
2017 March	23	17	40
2017 February	19	8	27
2017 January	28	5	33
2016 December	34	24	58
2016 November	49	18	67
2016 October	61	8	69
2016 September	44	11	55
2016 August	35	11	46
2016 July	26	10	36
2016 April	2	0	2

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