{
  "abstract": "Objectives: Why did you do this work? Errors on in-patient paediatric medication charts are common; with a reported incidence of 13%. 1 Prescribing errors can lead to patient harm, contributing to prolonged hospital stays and resultant financial implications for health boards.2 The baseline percentage of errors on in-patient medication charts for children newly admitted under the general paediatrics team at the Royal Glamorgan Hospital in South Wales was 20.3%. This project aimed to subsequently improve the overall prescribing standards for paediatric patients admitted to this hospital, through a reduction in the monthly error percentage to <10%.Methods: What did you do? An list of potential prescribing errors was generated and a proforma created, using a compilation of errors referenced from Styles et al. (2019).10 medication charts per week were audited for newly admitted general paediatric patients in February 2024, and the baseline percentage error calculated. 5-10 charts new charts per week were then audited from March until June 2024, with PDSA cycles implemented.PDSA 1 (March 2024): Project update poster & departmental update email.PDSA 2 (April 2024): Additional ‘Prescribing in Children’ teaching through the hospital’s foundation teaching programme.PDSA 3 (May 2024): Laminated A5 copies of the required prescribing standards were placed around paediatric wards as a reference for doctors and nurses.The outcome measure was the monthly error percentage. The process measure was the compliance (%) for prescribers stating the duration of time limited medications (e.g. oral antibiotics).Results: What did you find? 120 in-patient medication charts for children newly admitted to the Royal Glamorgan Hospital were audited between February and June 2024. The baseline error rate for February 2024 was 20.3%. The most common baseline errors (n=76), identified through a pareto analysis, were 37% (n=28) for not outlining the course length of time-limited medications (e.g. antibiotics, steroids etc.), 16% (n=12) for not prescribing the child’s regular medications on admission, 14% (n= 11) for not signing & dating appropriately when medications were stopped and 13% (n=10) for not stating medication strength/formulations.The monthly error percentages in March, April, May and June were 17%, 14.5%, 8.2% and 7% respectively. Compliance for correctly outlining course length of required medications on relevant prescriptions, such as for oral antibiotics and steroids, improved from 5% in February 2024 to 67% in June 2024. Dosing errors, excluding fluid based prescriptions which weren’t audited, remained low; with a total frequency of 1.6% (n=2) for regular and as required (PRN) medications.Conclusion: What does it mean? A quality improvement approach to improving paediatric prescribing practices within a district general hospital resulted in a sustained reduction in the monthly error percentage to <10% by the projects completion. This was a result of improved compliance for adopting key prescribing standards by prescribing clinicians. Future audit cycles will seek to sustain or improve upon this.References The incidence and nature of prescribing and medication administration errors in paediatric inpatients. Maisoon Abdulla Ghaleb, Nick Barber et al. 2010.Safe prescription for Junior Doctors in Accordance with All Wales Prescribing Standards. Mavra Naz, Adil Umer Khan et al. 2021.STAMP: a continuous improvement approach to improve paediatric prescribing and medication safety. Katherine Styles, Ashifa Trivedi et al. 2019.",
  "authors": [
    {
      "affiliations": [
        "Cardiff and Vale University Health Board"
      ],
      "name": "Peter Eriksen"
    }
  ],
  "title": "7742 Safer prescribing in children: a quality improvement approach to improving the prescribing practices within a district general hospital in South Wales",
  "uid": "a792233a-b33a-5c5a-9185-1d5cde2f4bf3"
}