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1276 Strive to prescribe and do no harm

Archives of disease in childhood, 2022-08, Vol.107 (Suppl 2), p.A483-A483 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ;2022 Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2022-rcpch.780

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  • Title:
    1276 Strive to prescribe and do no harm
  • Author: Rai, Kopila ; Aung, Wynn ; Junaid, Ebraheem ; Driscoll, Sarah ; Roe, Laura
  • Subjects: Abstracts ; Audits ; COVID-19 ; Medical errors ; Patients ; Pediatrics
  • Is Part Of: Archives of disease in childhood, 2022-08, Vol.107 (Suppl 2), p.A483-A483
  • Description: AimsPrescribing medication is a common intervention and hence prescribing errors are not uncommon events. Ghaleb et al 2010 showed that 13% of paediatric prescriptions contain errors and recently Elliot et al 2020 estimated that 66 million of the 237 million prescription errors had potentially clinically significant outcomes. This has been highlighted following a recent critical incident and, as part of the learning recommendations, a multidisciplinary team approach was formed to improve departmental prescribing education. The aim was to reduce the number of prescribing errors, therefore reducing harm to patients and improving care. This was achieved through the joint efforts of trainees and ward pharmacist by developing a robust evidence based teaching programme not only at induction but as rolling sessions throughout the year which, due to COVID 19 restrictions, was delivered virtually on TeaIn conjunction there was also a revision of the induction prescribing test, regular review of the number of prescribing error incidents and drug chart audits with cycle completion and implementation of changes. The teaching programme and audits were started in December 2020 and are on-going.MethodsFrom December 2020 to May 2021, audits were undertaken initially using the GMC prescribing standards. We later revised the audit tool to reflect the standards defined in our hospital inpatient prescribing policy which incorporated the GMC standards. 30 random drug charts from across 3 paediatric inpatient wards were analysed every month with the aim to achieve greater than 90% in each standard (taking into account a baseline level of human error) and then to maintain this over time. To achieve this, learning from the audit was fed back to all members of the team via regular electronic and visual/verbal reminders and the teaching programme was amended to include troublesome topics. Adverse incidents were reviewed and teaching from this was also included in the teaching programme.ResultsSince December 2020, it took 6 months for the number of incidents due to prescribing errors to reduce from 14 in 6 months (December 2020-May 2021) to 10 in 6 months (June-November 2021). Audit results showed that since December 2020 we were scoring >90% in 3 out of the 10 domains. 3 months into the teaching programme this improved to 4 out of 10 of the domains and at 6 months, 6 out of 10 domains. When we re-audited with our revised audit tool, we achieved >90% initially in 10 out of 16 domains and then consistently maintained our standards across 11-12 out of 16 domains over a 4 month period (October 2021-January 2022).ConclusionThis project has shown that despite a global pandemic, a combination of innovation, education, technology, multidisciplinary skills and team-working can implement and embed change to improve patient safety. When considering the bigger picture, we are reminded that this is a small part of the larger systemic processes that can influence medication errors and that with perseverance, we can aim to reduce the risk of adverse events due to medication errors and therefore provide the best care for our patients.
  • Publisher: London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
  • Language: English
  • Identifier: ISSN: 0003-9888
    EISSN: 1468-2044
    DOI: 10.1136/archdischild-2022-rcpch.780
  • Source: Alma/SFX Local Collection
    ProQuest Central
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