Decreasing Prescribing Errors in Antimicrobial Stewardship Program-Restricted Medications.

Area of Science:

• Pediatric Healthcare
• Quality Improvement Science
• Pharmacology

Background:

• Antimicrobial stewardship programs (ASPs) are crucial for regulating antimicrobial use but can inadvertently increase prescribing errors.
• Restricted antimicrobial prescribing necessitates careful workflow management to maintain patient safety.

Purpose of the Study:

• To decrease the proportion of prescribing errors associated with antimicrobial stewardship program (ASP)-restricted medications.
• To standardize workflows to improve the accuracy of prescribing ASP-restricted medications.

Main Methods:

• A quality improvement project utilized the Model for Improvement framework on inpatient units of a tertiary care children's hospital.
• Interventions included standardizing communication, medication review, implementing protocols, and developing electronic health record safety nets.
• Plan-Do-Study-Act cycles were employed to iteratively refine interventions for reducing prescribing errors.

Main Results:

• The proportion of prescribing errors for ASP-restricted medications decreased from 10.9% at baseline to 4.6% after intervention.
• The mean time between prescribing errors increased from 2.9 days to 8.5 days, indicating a sustained improvement.
• These positive outcomes were sustained throughout the study period and a subsequent 3-month monitoring phase.

Conclusions:

• Quality improvement methodologies are effective in reducing prescribing errors for ASP-restricted medications.
• Standardized workflows can lead to sustained improvements in medication safety within a pediatric hospital setting.
• This project demonstrates a successful strategy for enhancing antimicrobial stewardship outcomes.