TABLE 3.

Sources of error in the paediatric emergency setting

Improper identification of the patient

Patients may be unfamiliar to the nurse or physician; patients are often moved from one room to another due to needs of the department; different spoken language and similar sounding names may lead to confusion

Presence of trainees

Nonpaediatric trainees who may be less familiar with paediatric dosing

Inadequate nursing staff or nursing shortage

Younger, less experienced nurses may not recognize a potential error

Overcrowding

Increased demands on staff, limited space and hallway examinations are compromised

Inadequate support staff

Stress

Rapid decisions, incomplete information and frequent interruptions

Fatigue

Cognitive function decreases with sleep deprivation: after 24 h, psychomotor function is impaired similar to having blood alcohol level of 0.1%; physicians who do not recognize the effect of sleep deprivation on their performance

Communication

Change of shift, patients who speak a different language, interpreters who may not represent history accurately or give erroneous directions

Adpated from reference 27