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Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors
1Department of Oral Surgery, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Journal of Clinical Pharmacy and Therapeutics
|January 4, 2014
Summary
Paediatric drug prescribing errors are common, particularly with weight-adjusted doses, leading to potential under-dosing and reduced medication efficacy. Simple interventions can improve accuracy in prescription chart completion and dosing calculations.
Area of Science:
- Medical Research
- Paediatric Pharmacology
- Surgical Patient Care
Background:
- Drug prescribing is critical in inpatient care, with errors having severe consequences.
- Paediatric prescribing is especially vulnerable due to weight-adjusted dosing.
- Previous adult studies show high error rates; paediatric data and weight-adjusted dose accuracy are lacking.
Purpose of the Study:
- To quantify errors in paediatric drug prescribing for oral and maxillofacial surgery patients.
- To explore practical methods for reducing prescribing errors in this population.
- To assess the accuracy of weight-adjusted dosing in paediatric inpatients.
Main Methods:
- Retrospective evaluation of inpatient drug charts in a children's hospital.
- Assessment of prescribing practices against established hospital standards.
- Analysis of weight-adjusted dose variability to set auditing targets.
Main Results:
- Prescriptions were written by maxillofacial and anaesthetic teams with similar error rates.
- 13% of drug charts had errors in frequency prescribing.
- Weight-adjusted doses showed a median under-dosage of -5.4% (IQR -12% to -0.6%).
Conclusions:
- Prescription chart completion errors and weight-adjusted dose inaccuracies are frequent in paediatric patients.
- Under-prescribing of weight-adjusted doses may reduce drug efficacy, e.g., analgesia.
- Specialty-specific interventions can enhance the accuracy of drug chart completion and weight-adjusted dosing.
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