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Table 2 Principles of dosing error, agreement statement, and proportion of consensus agreementa for each statement

From: A modified Delphi to define drug dosing errors in pediatric critical care

  Proportion of agreement (%)
Round agreement achieved
YES, DEFINITELY constitutes a dosing error
 Dosing a drug above reference range, but the drug dose was intercepted (near-miss) and did not reach patient 76 Round 1
 Dosing a drug below the minimum recommended dose, when the drug is possibly life-saving 73 Round 2
YES, PROBABLY constitutes a dosing error
 Dosing a drug in a dose that is predicted to give serum levels below desired therapeutic range (e.g. 50% below lower limit target) 62 Round 2
 Dosing a drug by weight, without accounting for a significant drug interaction 68 Round 3
 Dosing a drug in a dose that is likely to give serum levels above desired therapeutic range (e.g. 50% above upper limit target) 60 Round 2
MAY or MAY NOT be a dosing Error
 Dosing a drug by weight, without adjusting for age 76 Round 2
 Dosing a drug by weight, without accounting for body surface area 73 Round 1
 Dosing a drug dose above the maximum dose recommended in the hospital formulary, guideline or reference sources 66 Round 2
 Dosing a drug above the maximum recommended dose, in a patient who is in end-of life care 71 Round 2
 Dosing a drug above the maximum recommended dose in a patient who is on ECMOb 82 Round 2
 Dosing a drug above the maximum recommended dose, when the drug is possibly life-saving (e.g. antibiotics in sepsis) 60 Round 2
 Dosing a drug by weight, without adjusting for renal insufficiency (Creatinine 50% higher than baseline) 69 Round 3
NO, UNLIKELY to constitute a dosing error
 Dosing a drug dose that cannot easily be administered using dosage forms available 66 Round 2
NO, DEFINITELY NOT a dosing error
 None  
Dosing a drug at a dose where the patient has had a previous severe adverse event Partial agreementc
Dosing a drug for which the use is off-label in children (i.e. prescribed for a condition that it is not officially approved for) Partial agreementd
  1. N for Round 1 is 42, N for Round 37, N for Round 3 is 36
  2. aConsensus agreement established a priori was > = 70% for Round 1, and > =60% for Rounds 2 and 3.
  3. bECMO: Extra-Corporeal Membrane Oxygenation.
  4. cN = 21 (58%) responded “Yes, definitely dosing error”, N = 1 “Yes, probable dosing error” and N = 14 (39%) “May or May not be error”. N total = 36 participants.
  5. dN = 20 (55%) “No Definitely not a dosing error”, N = 12 (33%) “No, probably not a dosing error”, N = 3 (8%) “May or may not be a dosing error”, N = 1 (3%) “I don’t know”. N total = 36 participants.