Recording inpatient weight: implications for medicines administration

Area of Science:

• Clinical Pharmacy
• Patient Safety
• Healthcare Quality Improvement

Background:

• Accurate patient weight is crucial for appropriate drug dosing and nutritional assessment in hospital settings.
• Inconsistent recording of patient weights can lead to suboptimal clinical care and potential adverse events.
• Previous studies have highlighted variability in clinical data recording, but specific focus on weight is needed.

Purpose of the Study:

• To determine the proportion of hospital inpatients with documented weights.
• To assess the percentage of patients receiving weight-based medications who have recorded weights.
• To identify variations in weight recording practices across different hospital settings.

Main Methods:

• A survey of clinical notes was conducted in November 2011.
• Data were collected from a convenience sample of 11 secondary and tertiary referral hospitals in England and Wales.
• 1068 inpatients were included in the study, with 1061 clinical notes available for analysis (99.3% availability).

Main Results:

• Nearly all pediatric patients had recorded weights (98.7%).
• Only 51.2% of adult inpatients had recorded weights, with significant inter-hospital variation (13.5% to 92.5%).
• Among patients receiving gentamicin or therapeutic-dose low molecular weight heparin (t-LMWH), 64.5% had a recorded weight.

Conclusions:

• A substantial proportion of adult inpatients lack recorded weights, impacting clinical decision-making.
• Significant disparities in weight recording exist across hospitals, suggesting systemic issues.
• Inadequate weight documentation may increase patient risk for adverse drug reactions and malnutrition-related complications.