Background A recent UK study showed that the prevalence of medication errors in children could be as high as 13.2% compared to a previously documented range of 2–14%. To tackle this, a pharmacist led session for all new junior doctors rotating into paediatrics was instigated in a DGH to raise awareness of the issues associated with prescribing in children.
Aim To implement prescribing audit and training sessions to all grade of paediatric medical staff.
Method To further evaluate and enhance the impact of the induction training, an audit was developed based upon the Trust Medicines Management ten prescribing standards. All doctors in attendance at a regular training meeting were split into two groups, each with a mix of grade of staff. Each group evaluated five drug charts taken from the inpatient ward, against the Trust standards. Results were fed back immediately using computer software with time for reflection and discussion followed by a presentation regarding the implications of poor prescribing. Feedback was sought from participants following the session. The audit was carried out twice during the junior rotation, to identify improvements and concerns.
Results A total of 22 doctors attended the sessions. Adherence to the overall standards improved from 58 in the 1st session to 72% in the 2nd. An improvement was seen in six standards, compliance maintained in two and a fall in compliance noted in two standards. A further re-audit over a three week period found an improvement in these two deteriorated standards, with an overall adherence of 90%. Feedback from the sessions was very positive with a suggestion for other audits to be carried out in a similar format. A three week audit at another paediatric unit within the same Trust where no similar training sessions were performed found adherence to the standards of 70%.
Conclusion The introduction of a programme which utilised the prescribers themselves enabled a level of engagement and a greater understanding of the standards required. A significant improvement in prescribing was noted over the period of assessment which, following repeated sessions, is expected to be maintained.
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