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首页> 外文期刊>Journal of Clinical Pharmacy and Therapeutics >Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors
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Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors

机译：儿科常见剂量错误的证据，并采取干预措施以减少此类处方错误

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What is known and objective Drug prescribing is an essential part of inpatient care, and prescription errors/omissions have the potential to lead to disastrous consequences. Paediatric inpatient prescribing is particularly sensitive to error due to the weight-adjusted dosing of many medications prescribed in the acute setting. Previous studies have described a high incidence of error in adult drug chart completion, although no studies to date have assessed the error seen in the paediatric setting or accuracy of weight-adjusted dosing. Our objective was to determine the degree of error seen in paediatric drug prescribing for patients admitted under the care of oral and maxillofacial surgery and to explore practical and accessible methods through which error can be reduced. Methods We retrospectively evaluated inpatient drug charts to assess the prescribing practices seen for patients admitted under the care of oral and maxillofacial surgery in an NHS children's hospital and compared these findings against established hospital standards. The study also examined the distribution and variability of weight-adjusted dose prescribing in an attempt to set targets for auditing improvements following the implementation of changes. Results and discussion Prescriptions were completed by a combination of doctors from maxillofacial and anaesthetic teams, with similar error rates seen in both specialties. 13% of drug charts contained one or more errors in frequency prescribing. For weight-adjusted drugs, a median under-dosage of -5·4% was noted, with an IQR of -12 to -0·6. Our study has confirmed that errors are common both in the manual completion of paediatric prescription charts and in the calculation of weight-adjusted doses. What is new and conclusion We conclude that inaccuracies in prescription chart completion are a frequent occurrence and that dosage and frequency-prescribing errors may potentially act synergistically to create a significant disparity between the recommended and actual amount of drug that is delivered. Our study demonstrates a clear bias towards under-prescribing weight-adjusted doses which may be contributing to reduced efficacy of analgesia, among other drugs. Simple methods can be implemented on a specialty basis to improve the accuracy of both drug chart completion and weight-adjusted dosing. The objective was to determine the degree of error seen in paediatric drug prescribing for patients admitted under the care of oral and maxillofacial surgery and to explore practical and accessible methods through which error can be reduced. The study also examined the distribution and variability of weight-adjusted dose prescribing in an attempt to set targets for auditing improvements following the implementation of changes. Our study demonstrates a clear bias towards under-prescribing weight-adjusted doses which may be contributing to reduced efficacy of analgesia, among other drugs. Simple methods can be implemented on a specialty basis to improve the accuracy of both drug chart completion and weight-adjusted dosing.
机译：已知和客观的药物处方是住院护理的重要组成部分，处方错误/遗漏可能导致灾难性后果。由于急性环境中规定的许多药物的重量调整剂量，小儿住院处方对错误特别敏感。先前的研究描述了成人药物图表完成中错误的发生率很高，尽管迄今为止尚无研究评估儿科环境或体重调整剂量准确性中的错误。我们的目标是确定在口服和颌面外科手术治疗下入院的患者开出的儿科药物处方中出现的错误程度，并探索可以减少错误的实用且容易获得的方法。方法我们回顾性评估了住院药物图表，以评估在NHS儿童医院接受口腔颌面外科手术治疗的患者的处方操作，并将这些发现与既定的医院标准进行比较。该研究还检查了体重调整剂量处方的分布和变异性，以期为变更实施后的改进制定目标。结果与讨论处方由上颌面和麻醉小组的医生共同完成，在两个专业中看到的错误率相似。 13％的药物图表在频率处方中包含一个或多个错误。对于重量调整后的药物，中度剂量不足为-5·4％，IQR为-12至-0·6。我们的研究已经证实，在手动完成儿科处方表和计算体重调整剂量中，错误都是常见的。新增内容和结论我们得出的结论是，处方表填写不准确是经常发生的情况，并且剂量和频率规定错误可能会协同作用，从而在建议的和实际交付的药物量之间产生巨大差异。我们的研究表明，偏重于调整体重的剂量处方不足，这可能会导致其他药物的镇痛效果降低。可以在专业基础上实施简单的方法，以提高药物图完成和重量调整剂量的准确性。目的是确定在口服和颌面外科手术治疗下入院的患者在小儿处方中看到的错误程度，并探索可以减少错误的实用且可及的方法。该研究还检查了体重调整剂量处方的分布和变异性，以期为变更实施后的改进制定目标。我们的研究表明，偏重于调整体重的剂量处方不足，这可能会导致其他药物的镇痛效果降低。可以在专业基础上实施简单的方法，以提高药物图完成和重量调整剂量的准确性。

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