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Intervention monitoring in paediatrics as a strategy to improve prescribing

By Nanna Christiansen, Alice Lo and Andrew Law

Abstract

Aim

To describe a system of regular intervention monitoring among paediatric patients and how the information is used to inform the content of different strategies aimed at improving prescribing practice.

Design

Pharmacist Interventions were recorded using an intervention form. The design was based on the 2006 Pharmaceutical Care Network Europe (PCNE) classification scheme. Subcategories for paediatric pharmacy use were developed and all interventions reviewed by a second pharmacist to ensure the validity of the results. A Microsoft Access database was developed for data collection and analysis. 

Subjects and setting

All paediatric inpatients at the Royal London Children’s Hospital were included. The hospital has 130 beds covering a wide range of tertiary specialties.

Results

In total 377 interventions were recorded over a six-month period. Most interventions (58 per cent) were due to dosing problems, where patients were dosed incorrectly for weight, age and indication. Errors in drug choice triggered 25 per cent of interventions and drug use 13 per cent. Within the latter two categories 41 per cent were caused by incorrect drug history reconciliation. Most interventions were deemed minor in severity, with 38 per cent classed as moderate and less than 1 per cent as major errors. The data collected informed the content of different strategies to improve prescribing practice, including intervention bulletins, tailoring of doctor induction and a prescribing test and training for pharmacy staff.

Conclusion

The intervention form is a tool that is easy to use, which can provide valuable data to guide educational strategies and increase awareness of a variety of prescribing errors.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11124898

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