Evaluation and Implementation of KIDs List Recommendations in a University Health System

Area of Science:

• Pediatric pharmacology
• Medication safety
• Health informatics

Background:

• The Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List identifies medications to avoid in children.
• Assessing the implementation of safety measures for KIDs List medications is crucial for pediatric patient safety.

Purpose of the Study:

• To determine the rate of inappropriate prescribing of KIDs List medications.
• To evaluate the presence and effectiveness of safety measures for these medications in a hospital setting.

Main Methods:

• Retrospective evaluation of medication orders and adverse event reports for KIDs List medications.
• Analysis of safety measures including age/weight filtering, dose-range checking, clinical decision support, and override availability.
• Exclusion of medication errors from adverse event analysis.

Main Results:

• 39 inappropriate orders and 4 possible adverse events were identified.
• Low implementation rates for safety measures: 24% had age/weight filtering, 2.6% had dose-range checking, 0% had active clinical decision support alerts.
• High availability of automated dispensing cabinet overrides (87%) was noted.

Conclusions:

• While the use of KIDs List medications is low, indicating appropriate prescribing in many cases.
• Insufficient implementation of key safety measures leaves pediatric patients at risk for potential harm.
• Enhanced safety measure integration is recommended to improve pediatric medication safety.