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Accurate Dosing Weight: When the 10% Really Matters

Swaminathan Kandaswamy1, Sarah Thompson2, Evan Orenstein1,2

  • 1Emory University School of Medicine, Atlanta, GA, USA.

Studies in Health Technology and Informatics
|January 25, 2024
PubMed

Insights

Medication dosing errors in children are reduced by a new clinical decision support system. This system improves weight accuracy, decreasing dosing discrepancies and enhancing patient safety.

Area of Science:

  • Pediatric Pharmacology
  • Health Informatics
  • Patient Safety

Background:

  • Children face higher risks of medication errors, frequently stemming from inaccurate weight-based dosing.
  • Weight-based dosing errors contribute significantly to adverse drug events in pediatric populations.

Purpose of the Study:

  • To decrease the percentage of medication administrations where the dosing weight differed by 10% or more from the recorded patient weight.
  • To enhance the accuracy of medication dosing for pediatric patients.

Main Methods:

  • In-situ usability testing was employed to refine clinical decision support tools.
  • The system prompted clinicians to update patient weights if the recorded weight differed by over 10% from the last recorded weight, especially after 7 days.

Main Results:

  • The proportion of medication administrations with a >10% weight difference decreased from 13.1% to 9.5% (P < 0.001).
  • This intervention demonstrated a statistically significant reduction in dosing weight inaccuracies.

Conclusions:

  • User-centered design of an interruptive alert effectively improved dosing weight accuracy during medication administration.
  • In-situ usability testing proved valuable for rapid feedback and iterative design, leading to desired behavioral changes in clinicians.
Abstract

Keywords:
Clinical decision supportmedication safety

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