Aim: The aims were to characterise paediatric medication errors and to identify the prevalence of known high‐alert substances in these errors.Methods: All paediatric drug‐related incident reports and complaints nationally reported to the Health and Social Care Inspectorate in Sweden 2011‐2017 regarding inpatients were characterised by context and modal details. In addition, drug use at a university hospital was matched to local incident reports. Drug substances were classified using three high‐alert lists.Results: On a national level, there were 160 reports (2.5 per 10 000 patients) in which the three high‐alert lists were found in different degrees (17/35/47%). Morphine (n = 12), vancomycin (n = 11) and potassium (n = 7) were most frequently involved. Eighty per cent of the reports concerned patients aged 0‐6 years. Intravenous was the most common route of administration (66%). On a university hospital level, the prevalence of all types of drug incidents reports was 1.7% among all inpatients. The prevalence of local incident reports involving high‐alert substances was almost double that of non‐alert substances.Conclusion: Existing high‐alert drug lists are relevant for paediatric inpatients. A higher awareness and usage of such lists among hospital staff prescribing, dispensing and administering drugs to children may have the potential to reduce medication errors.

The gene transfer mediated by chitosan in CFBE41o⁻ (a cystic‐fibrosis bronchial epithelial cell line) and HEK (a human embryonic kidney cell line) has been evaluated. Polyplexes based on chitosan and PEI (polyethyleneimine) using a luciferase and enhanced green fluorescent protein reporter plasmid showed that the transfection efficacy of polyplexes in the CFBE41o⁻ cell line was poor compared with that in HEK cells. In the highly differentiated cystic‐fibrosis bronchial epithelial cell line the narrow‐size‐distributed chitosan shows enhanced transfection at a low pH compared with PEI. The enhanced transfection at lower pH could be a result of damage to the cell surface or changes in the cell‐surface charge, leading to better penetration of the cell membrane.

Purpose: The objectives of our study were to determine drug use, type and incidence of all adverse event associated with drug or drug-related processes (Adverse Drug Events, ADE) among pediatric inpatients in relation to hospital unit and length of stay. Patients and Methods: 600 pediatric (0– 18 years) admissions at a Swedish university hospital during one year were included and stratified in blocks to 150 neonatal, surgical/orthopedic, medicine and emergency-medicine unit admissions, respectively. Adverse events were identified from medical records using a pediatric trigger tool. All triggers identifying an adverse event related to drugs and drug-related devices were included. Data on drug use were extracted from the hospital drug-data warehouse. Results: In total, 17794 daily drug orders were administrated to 486 (81.0% exposed) admissions. Parental nutrition, potassium salts and morphine constituted half of all high-risk drugs prescribed. Two-thirds of intravenous irritating drug doses consisted of vancomycin, esomeprazole and meropenem. In 129 (21.5%) admissions, at least one ADE was identified, out of which 21 ADE were classified as more severe (National Coordinating Council Medication Error Reporting Prevention-Index, NCCMERP≥F). The ADE incidence was 47.4 (95% confidence interval: 39.4– 57.3) per 1000 admission days and varied by unit category. In neonatal units, 56.9 (49.5– 65.4) ADEs/1000 admission days were detected, in surgery/orthopedic 54.2 (40.3– 72.8), in medicine 44.1 (33.1– 58.7), and in emergency-medicine 14.3 (7.7– 26.7) ADEs/1000 admission days were found. The most common types of ADEs were identified by triggers that were not directly aiming at drugs including insufficiently treated pain (incidence peaking already in the first days), skin, tissue or vascular harm (peaking at the end of the first week) and hospital-acquired infections (peaking in later admission days). Conclusion: Adverse drug events are common in pediatric patients. The incidence of ADEs and type of ADE varies by hospital unit and length of hospital stay.

Aim: To explore the incidence and characteristics of inpatient neonatal adverse events in a Swedish setting.Methods: A retrospective record review, using a trigger tool, performed by registered nurses and a neonatologist, at a University Hospital. The identified adverse events were categorised by, for example, preventability, severity and time of occurrence.Results: A random selection of 150 admissions representing 3531 patient days were reviewed (mean [SD] birthweight 2620 [1120]g). Three hundred and sixty adverse events were identified in 78 (52.0%) infants, and 305 (84.7%) of these were assessed as being preventable. The overall adverse event rate was 240 per 100 admissions and 102.0 per 1000 patient days. Preterm infants had a higher rate than term infants (353 versus 79 per 100 admissions, p = 0.001); however, with regard to the length of stay, the rates were similar. Most adverse events were temporary and less severe (n = 338/360, 93.9%) and the most common type involved harm to skin, tissue or blood vessels (n = 163/360, 45.3%). Forty percent (n = 145) of adverse events occurred within the first week of admission.Conclusion: Adverse events were common in neonatal care, and many occurred during the first days of treatment. Characterisation of adverse events may provide focus areas for improvements in patient safety.

This is a registry-based study with the aim of describing and comparing the frequency of manipulations of solid oral and rectal medicines in 2009 and 2019 at inpatient units and an emergency department in a paediatric hospital within a Swedish university hospital. All patients aged 1 month–18 years with oral or rectal administrations were included. In total, 140,791 oral and rectal administrations were included in 2009, and 167,945 oral and rectal administrations were included in 2019. The frequency of patients receiving at least one manipulated oral medicine decreased between the study years, both in inpatient units and in the emergency department (from 19% to 17%, p = 0.0029 and from 11% to 5%, p < 0.0001, respectively). The frequency of patients receiving a manipulated rectal medicine also decreased between the study years, both in inpatient units and in the emergency department (from 22% to 10%, p < 0.0001 and from 35% to 7% 2019, p < 0.0001, respectively). The results show a decrease in the manipulation of both oral and rectal medicines to paediatric patients in 2019 compared to 2009. Even though this implies a safer practice, there is still a pronounced lack of child-friendly dosage forms and suitable strengths enabling the safe administration of medicines to sick children.

Background and Objectives: Neonates and children are at high risk of medication errors (ME) with intravenous (IV) infusion therapies, particularly when strategies such as the “rule of six” with individualized, weight-based concentrations are used. Standard concentrations (SCs) have been proposed to reduce variability, improve safety, and facilitate the use of electronic prescribing and smart infusion technologies. The impact of SCs for continuous IV infusions on ME rates in neonatal and pediatric settings was systematically evaluated. Methods: A systematic review was conducted in MEDLINE, Embase and CINAHL (database inception-August 2025) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies implementing SCs for neonatal or pediatric IV infusions and measuring outcomes referring to ME rates were included. The relative risk reduction/increase in MEs was calculated. Results: Five uncontrolled before-after studies published between 2005 and 2020 were included. The relative risk reductions ranged from 41.2% to 95.1% for overall ME and from 49.7% to 100% for selected error types. In two studies, the relative risk for two error types (paper-generated prescriptions, administration) increased after implementing SCs. Reviewed benefits included decreased calculation and preparation errors, reduced medication process times, improved workflow efficiency and high staff satisfaction. Conclusions: SCs may contribute to safer IV infusion practice in the neonatal and pediatric setting, especially combined with smart technologies and training. However, current evidence is limited and heterogeneous. Larger, prospective experimental studies are needed to confirm their long-term impact on pediatric ME rates.