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G360(P) Improving paediatric prescribing
  1. LE Durant1,
  2. M Aye1,
  3. S Brown2
  1. 1Paediatrics, Milton Keynes Hospital, Milton Keynes, UK
  2. 2Paediatric Pharmacy, Milton Keynes Hospital, Milton Keynes, UK


The aim of this audit is to reduce prescribing errors in a local hospital paediatric department. Prescribing errors have the potential to cause harm to children in hospital and improvements must be made to ensure their safety. Children are at increased risk from prescribing errors as prescriptions require dose calculations. Also it has been shown that the adverse drug reaction rate is three times more likely in children compared to adults. Prescribers’ are required to follow GMC safe prescribing guidelines and failure to do so will affect their registrations. The audit identifies prescribing errors and recommends a strategy to improve local hospital practice based upon the RCPCH Paediatric Prescribing Tool (PPT).

Data was collected in April 2015 from prescription charts of all paediatric inpatients. Data were compared to standards set by local hospital prescribing guidelines that state prescriptions should have the right patient details including allergy information, the right medication details and the right prescribers’ details. Prescriptions should be legible in black ink and appropriate drugs should have a review date.

A total of 234 prescription errors were made. 166 (70.9%) errors were from medication details. 68 (29.0%) errors were from use of trade names, poor legibility of prescription and inappropriate review information. Of the errors made on medication details 25 (10.6%) were serious errors from wrong prescriptions and 141 (60.2%) were less serious. 7 (3%) serious errors were due to the wrong dose and 4 (1.7%) were due to the wrong frequency. 44 (18.8%) less serious errors were due to missing timings and 16 (6.8%) were due to missing the maximum frequencies.

We have identified prescribing errors which have the potential to cause harm. To maximise learning from this audit, results were presented each week at handover after data collection. To minimise prescribing errors pharmacy staff will recommend prescribers’ making multiple errors to initiate early intervention and training. In response to the RCPCH Paediatric Prescribing Tool prescribing tutorials with quizzes will be introduced for all staff on induction to the paediatric department to reduce prescribing errors. A re-audit will be carried out to determine the outcome of these improvement strategies.

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