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For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review
Charlotte King1, Jan Dudley2, Abigail Mee3
1Department of Women and Child's Health, University of Liverpool Faculty of Health and Life Sciences, Liverpool, UK.
Insights
Interventions like checklists and pharmacist involvement may reduce prescribing errors in pediatric hospital wards. However, more robust studies are needed to confirm their impact on overall medication safety for children.
Area of Science:
- Pediatric patient safety
- Clinical pharmacy interventions
- Medication error reduction
Background:
- Medication errors pose a significant risk to hospitalized children annually.
- Effective strategies to enhance medication safety during pediatric ward rounds are needed.
Approach:
- Systematic review of randomized controlled trials and observational studies.
- Included studies focused on interventions during inpatient ward rounds for children aged 0-18 years.
- Evaluated interventions aimed at improving medication review and prescribing practices.
Key Points:
- Three studies were reviewed, examining interventions such as acrostics, checklists, and pharmacist involvement.
- Interventions showed reductions in prescribing errors.
- No studies reported reductions in clinical harm or specifically addressed weight-based errors.
Conclusions:
- Limited data exists on interventions to improve pediatric ward round medication safety.
- Current evidence comes from small-scale quality improvement projects or audits.
- High-quality interventional studies are necessary to establish effective strategies for improving medication safety in pediatric ward rounds.
Objective:
Every year, medication errors harm children in hospitals. Ward rounds are a unique opportunity to bring information together and plan management. There is a need to understand what strategies can improve medication safety on ward rounds. We systematically reviewed published interventions to improve prescribing and safety of medicines on ward rounds.
Design:
Systematic review of randomised controlled trials and observational studies.
Setting:
Studies examining inpatient ward rounds.
Patients:
Children and young people aged between 0 and 18 years old.
Interventions:
Any intervention or combination of interventions implemented that alters how paediatric ward rounds review inpatient medications.
Main Outcome Measure:
Primary outcome was improvement in medication safety on paediatric ward rounds. This included reduction in prescribing error rates, healthcare professionals' opinions on prescribing and improvement in documentation on ward rounds.
Results:
Three studies were eligible for review. One examined the use of an acrostic, one the use of a checklist, and the other a use of a specific prescribing ward round involving a clinical pharmacist and doctor. None of the papers considered weight-based errors or demonstrated reductions in clinical harm. Reductions in prescribing errors were noted by the different interventions.
Conclusions:
There are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds.
Prospero Registration Number:
CRD42022340201.
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