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Prevalence of Unrounded Medication Doses and Associated Factors Among Hospitalized Pediatric Patients

Aubrey N Jones, Jamie L Miller, Stephen Neely

    The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
    |September 26, 2017
    PubMed

    Insights

    Unrounded doses ordered via computerized prescriber order entry (CPOE) systems are prevalent in pediatric care. Smaller children had a higher prevalence of unrounded doses, suggesting a need for improved CPOE system safety features.

    Area of Science:

    • Pediatric pharmacology
    • Medication safety
    • Health informatics

    Background:

    • Computerized prescriber order entry (CPOE) systems aim to improve medication safety.
    • Unrounded doses, which are difficult to measure accurately, pose a risk in pediatric medication administration.
    • Previous studies have highlighted the issue of unrounded doses, but prevalence in relation to CPOE systems requires further investigation.

    Purpose of the Study:

    • To determine the prevalence of unrounded doses ordered through a CPOE system in pediatric patients.
    • To identify factors associated with the occurrence of unrounded doses in this population.

    Main Methods:

    • A retrospective, cross-sectional study was conducted over a 1-week period.
    • Included were pediatric patients (<18 years) admitted during the study period.
    • Unrounded doses were defined by specific criteria for actual dose and volume per dose, differing for neonatal intensive care unit (NICU) and non-NICU patients. A multilevel logistic regression model was employed.

    Main Results:

    • The overall prevalence of unrounded doses was 30% among 2426 administered doses.
    • Patients in the NICU had the highest prevalence of unrounded doses.
    • Increased patient weight was associated with a decreased odds of unrounded doses (adjusted odds ratio, 0.96).

    Conclusions:

    • The prevalence of unrounded doses in pediatric patients via CPOE was higher than previously reported.
    • Smaller children were found to have a higher prevalence of unrounded doses.
    • Future research should explore CPOE's role in preventing unrounded and unmeasurable doses and their impact on clinical outcomes.
    Abstract

    Keywords:
    computerized prescriber order entrydose roundingmedication safetymedicationspediatricsrounding tolerance

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