Impact of clinical pharmacist interventions in reducing paediatric prescribing errors
- Cecilia M Fernández-Llamazares1,
- Miguel A Calleja-Hernandez2,
- Silvia Manrique-Rodriguez1,
- Cristina Pérez-Sanz1,
- Esther Duran-García1,
- Maria Sanjurjo-Saez1
- 1Pharmacy Service, Gregorio Marañón General University Hospital, Madrid, Spain
- 2Pharmacy Service, Hospital Virgen de las Nieves, Granada, Spain
- Correspondence to Cecilia M Fernández-Llamazares, Pharmacy Service, Hospital General Universitario Gregorio Marañón, C/ Doctor Esquerdo 46, 28007 Madrid, Spain;
Contributors CMF-L was the lead author and wrote the final version of the manuscript. She designed the study, working together with the other authors to define the variables, and also carried out the overall statistical analysis of the data, together with Jose María Bellón. MACH helped to design the study, defined the variables and checked the statistical analyses, and critically reviewed the text. SM-R created the database used to store the variables, helped to define the variables and code each of the interventions, and reviewed the final text. CP-S created the database used to store the variables together with SM-R, helped to define those variables and code each of the interventions, and reviewed the final text. ED-G helped to define the variables and code each of the interventions, and reviewed the final text. MS-S helped to design the study, define the variables and check the statistical analyses, and critically reviewed the text.
- Received 25 October 2011
- Accepted 12 January 2012
- Published Online First 22 February 2012
Objective To assess the impact of pharmacist intervention in reducing prescribing errors in paediatrics, and to analyse the clinical significance and reasons behind the errors detected.
Methods Cross-sectional epidemiological study analysing the activities of the paediatric pharmacist in a maternity and children's hospital with 180 paediatric beds, between January 2007 and December 2009. The following variables were analysed: impact of the pharmacist's recommendation on patient care, reason for the intervention, clinical significance, type of negative outcome associated with the medication, acceptance rate, medication involved, intervention detection date and observations.
Results A total of 1475 interventions in medical orders for 14 713 paediatric patients were recorded (40 (2.9%) extremely significant interventions and 155 (11.1%) very significant interventions). There were 1357 prescribing errors, 833 of which were dosing errors. 2.2% of the errors detected were potentially fatal (30 cases) and 14.3% (194 cases) were clinically serious. The main reason for interventions was detection of a dosage between 1.5 and 10 times higher than that recommended. The overall rate of acceptance of the pharmacist's suggestions was 94.3%. The pharmacist carried out an average of 0.019 interventions per patient day throughout the study period.
Conclusion Interventions by a clinical pharmacist had a major impact on reducing prescribing errors in the study period, thus improving the quality and safety of care provided.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.