{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:14:02Z","timestamp":1783314842722,"version":"3.54.6"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parenteral nutrition and concentrated electrolytes are associated with medication errors in pediatrics; however, a systems\u2010based understanding of these errors is lacking. We aimed to describe the errors, contributing factors, and proposed defenses related to these medications in pediatrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study analyzed self\u2010reported medication safety incidents at a pediatric university hospital between 2018 and 2020, focusing on parenteral nutrition and concentrated electrolytes. The reports were investigated through qualitative content analysis, and the results were quantified in frequencies and percentages. Consequently, the Institute for Safe Medication Practices\u2032 Hierarchy of Effectiveness of Risk\u2010Reduction Strategies was used to categorize the proposed safety defenses. The analysis used a systems approach to medication risk management, guided by the theory of human error.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 404 medication errors, 627 contributing factors, and 386 proposed defenses were identified within the study sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009279 incident reports). Most errors occurred during the administration (54%) and preparation (25%) phases. Common issues included wrong dose (15%), wrong infusion rate (11%), and incorrectly prepared medicine (18%). Contributing factors were often linked to workload and resources (22%) and employee\u2010related factors (21%). Most proposed defenses were classified as low leverage (71%), with the smallest portion at the highest leverage (6%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Errors often occur during preparation and administration, primarily because of the complexity of individualized dosing. Contributing factors include high workload, limited resources, and employee\u2010related factors. Hospitals should prioritize implementing systems\u2010based, technology\u2010driven defenses over person\u2010focused strategies. Future research is essential for developing and evaluating child\u2010specific defenses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpen.70049","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:11:32Z","timestamp":1767787892000},"page":"374-384","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medication errors involving parenteral nutrition preparations and concentrated electrolytes in a pediatric hospital: A qualitative analysis"],"prefix":"10.1002","volume":"50","author":[{"given":"Justiina","family":"Tuomisto","sequence":"first","affiliation":[{"name":"Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Riia","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy University of Helsinki Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0170-892X","authenticated-orcid":false,"given":"Sini","family":"Kuitunen","sequence":"additional","affiliation":[{"name":"Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy University of Helsinki Helsinki Finland"},{"name":"HUS Pharmacy Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,7]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization (WHO)Medication without harm\u2014global patient safety challenge on medication safety. 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