{
  "abstract": "Background: Neonatal Units (NUs) are high-risk environments for medication errors (MEs), mainly due to complex weight/gestational age-based dosing and frequent off-label drug use. Although the incidence of serious harm is low, medication errors remain a major safety concern. The aim of this study was to have a snapshot of MEs errors within Italian NUs.\n\nMethods: The Neonatal Pharmacotherapy Study Group and the Risk Management and Simulation Study Group of the Italian Society of Neonatology (SIN) conducted a national cross-sectional web-based survey between 2022 and 2023. Responding NUs were stratified into two groups: those reporting fewer than five MEs per year (< 5 MEs/y )and those with five or more (≥ 5 MEs/y). Descriptive and inferential statistics were applied.\n\nResults: Prescription (33%) and drug preparation (29%) were the most frequently reported error types. The use of digital prescribing tools was higher in centers reporting fewer errors. Double-checking procedures limited to high-alert drugs was associated with higher error rates. 80% of NUs did not have a structured annual error report, and 55% failed to re-evaluate or implement corrective actions after identifying errors. Only 21% of NUs systematically informed families of therapeutic errors; as reasons for non-disclosure many centers citing the absence of harm or fear of legal/professional consequences.\n\nConclusions: While some centers adopt proactive safety strategies, others use incomplete protocols or outdated tools. The lack of systematic error reporting underscores the need for a cultural shift toward a constant analysis of this problem and a more continuous surveillance and evaluation of implemented safety strategies. A unified, anonymous digital reporting system could support error monitoring and targeted interventions at the local and national levels.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13052-026-02306-6.",
  "abstract_shown": true,
  "affiliations": [
    "Neonatology and NICU, Ospedale Provinciale, Bozen, Italy",
    "NICU, IRCCS S. Orsola, Bologna, Italy",
    "Neonatology and Pediatric, Ospedale Versilia, Viareggio, Italy",
    "Neonatology, Azienda Ospedaliera Universitaria, Pisa, Italy",
    "Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy",
    "NICU and Pediatry, ASReM, Ospedale A. Cardarelli, Campobasso, Italy",
    "Neonatology and NICU, Ospedale S. Eugenio, Rome, Italy",
    "NICU, Policlinico G. Rodolico S. Marco, Catania, Italy",
    "Neonatology and NICU, Ospedale S. Pietro Fatebenefratelli, Rome, Italy",
    "NICU, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy",
    "Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy",
    "Neonatology and NICU, Ospedale S. Giovanni Addolorata, Rome, Italy"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Luca Massenzi",
      "orcid": "0000-0002-4831-3570"
    },
    {
      "affs": [
        1
      ],
      "name": "Roberta Parladori"
    },
    {
      "affs": [
        2
      ],
      "name": "Luigi Gagliardi"
    },
    {
      "affs": [
        3
      ],
      "name": "Massimiliano Ciantelli"
    },
    {
      "affs": [
        4
      ],
      "name": "Gloria Brigiari"
    },
    {
      "affs": [
        5
      ],
      "name": "Francesco Crispino"
    },
    {
      "affs": [
        6
      ],
      "name": "Camilla Gizz"
    },
    {
      "affs": [
        7
      ],
      "name": "Nunzia Decembrino"
    },
    {
      "affs": [
        8
      ],
      "name": "Elena Sorrentino"
    },
    {
      "affs": [
        9,
        10
      ],
      "name": "Genny Raffaeli"
    },
    {
      "affs": [
        11
      ],
      "name": "Sabrina Palamides"
    },
    {
      "affs": [
        0
      ],
      "name": "Rocco Agostino"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/eb930ee1n25xg.bib",
  "cited_by": 0,
  "doi": "10.1186/s13052-026-02306-6",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13746486/",
  "id": "eb930ee1n25xg",
  "issns": [
    "1824-7288"
  ],
  "landing_url": "https://doi.org/10.1186/s13052-026-02306-6",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2739|Patient Safety and Medication Errors"
    ]
  ],
  "openalex": "W7202190408",
  "pdf_url": null,
  "pmcid": "PMC13746486",
  "pmid": "43000415",
  "published": "2026-08-11",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/eb930ee1n25xg.ris",
  "sources": [
    {
      "first_seen": "2026-11-11T12:23:49Z",
      "native_id": "PMC13746486",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13052-026-02306-6"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Patient Safety and Medication Errors",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Medical error in neonatal units: an Italian survey on national frequency and types of error",
  "title_text": "Medical error in neonatal units: an Italian survey on national frequency and types of error",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:22:53Z",
  "url": "https://research.draconitic.com/paper/eb930ee1n25xg",
  "venue": "Italian Journal of Pediatrics",
  "versions": []
}