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Does a Dose Calculator as an Add-On to a Web-Based Paediatric Formulary Reduce Calculation Errors in Paediatric
Tjitske M van der Zanden1,2,3, Matthijs de Hoog4,5, Jonathan D Windster4
1Department of Paediatrics, Erasmus MC, Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands. t.vanderzanden@erasmusmc.nl.
A new pediatric dose calculator integrated with a web-based formulary significantly reduced medication calculation errors among healthcare professionals. However, the technology introduced new error types, emphasizing careful development and use.
Area of Science:
- Medical Informatics
- Paediatric Pharmacology
- Clinical Pharmacy
Background:
- Accurate medication dosing is critical in paediatric care.
- Web-based formularies offer structured data for developing clinical tools.
- Digital tools can potentially improve medication safety in children.
Purpose of the Study:
- To develop and evaluate an integrated paediatric dose calculator.
- To assess the calculator's ability to reduce medication calculation errors in a simulated setting.
- To identify error types associated with both manual and calculator-assisted dosing.
Main Methods:
- A simulated study involving 77 healthcare professionals divided into manual calculation and dose calculator groups.
- Participants used a web-based questionnaire with 14 patient cases for dose calculations.
- Generalized estimating equations (GEE) logistic regression analyzed the probability of calculation errors.
Main Results:
- The dose calculator group had a lower mean probability of calculation error (24.4%) compared to the manual group (39.0%).
- A statistically significant difference in error reduction was observed (14.6%, p=0.013).
- New error types, such as transcription and parameter selection errors, emerged with calculator use.
Conclusions:
- The integrated paediatric dose calculator effectively reduces medication calculation errors.
- Development and implementation of dosing calculators require attention to potential new error sources like transcription and selection mistakes.
- Optimizing digital dosing tools is essential for enhancing paediatric medication safety.
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