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How do we ensure safe prescribing for children?
  1. Helen Sammons,
  2. Sharon Conroy
  1. Academic Division of Child Health (University of Nottingham), The Medical School, Derbyshire Children’s Hospital, Uttoxeter Road, Derby DE22 3DT, UK
  1. Sharon Conroy, Academic Division of Child Health (University of Nottingham), The Medical School, Derbyshire Children’s Hospital, Uttoxeter Road, Derby DE22 3DT, UK; sharon.conroy{at}nottingham.ac.uk

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Between January 2005 and June 2006 almost 10 000 medication safety incidents related to prescribing were reported to the UK National Patient Safety Agency, and over 80% of these occurred in hospitals.1 Children aged up to 4 years were involved in more than 10% of all incidents where age was stated, higher than the proportion of bed days they account for. This is likely to be an underestimate as it relies on a voluntary reporting scheme. However, the reluctance to report errors in the NHS is gradually changing as it is increasingly recognised that systems, not individuals, are usually to blame.

There has recently been debate in the medical press about the competency of medical professionals to prescribe. Aronson et al2 highlighted the fact that medical students and junior doctors may be unprepared for prescribing drugs when they qualify. Subsequent intense discussion led to a review by the General Medical Council (GMC) Education Committee of UK teaching and assessment of prescribing. This has prompted plans for research into the prevalence and causes of prescribing errors and recommendations about educational or ethical interventions to reduce them (see http://www.gmc-uk.org/education/documents/pap_prescribingITT_v1.0.pdf).

A core curriculum for teaching safe and effective prescribing in UK medical schools has been described.3 This mentions children in two sections:

  • Core knowledge and understanding should include prescribing for patients with special requirements because of their altered physiology, pharmacokinetic handling or pharmacodynamic responses

  • Core skills should include prescribing drugs in special groups.

However, further detail is not provided in either section.

Children are not small adults when it comes to either drug development or prescribing. The availability of information to support paediatric prescribing practice has improved in recent years with moves from the use of a plethora of paediatric formularies and dose guides based on local practice, to the …

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