Background and Aims Errors are common in paediatric inpatient prescribing. This audit cycle assessed the impact of new strategies aimed at reducing prescribing errors.
Methods Drug charts from short-stay admissions in January 2010 were assessed retrospectively. Two gold standards were used; local hospital prescribing guidelines and the British National Formulary for Children (BNFC) 2009. From these results, a number of strategies were implemented to improve practice: prescribing training for new doctors was enhanced; a mandatory prescribing competency assessment was introduced; awareness was raised through local and regional presentations; increasing the availability of BNFC in clinical areas; daily pharmacy endorsements of drug charts and provision of Doctors’ name stamps; and recommendations for a drug chart re-design. We then re-audited using identical methods in July 2010.
Results A total of 106 charts were assessed. Changes in documentation were found as follows:
Improvements: reason for non-administration (+26%), allergy status (+20%), at least one medication pharmacy-endorsed (+16%), date of birth (+5%), dose in mg/kg where applicable (+5%), frequency for all medications (+2%), ‘micrograms’ written in full (+1%).
No change: patient name (100%), no unofficial abbreviations (100%), weight (96%), signature when administered (96%).
Worsening: appropriate decimals (–6%), doctor’s name stamp (–6%), start date (–5%), total dose (–2%), administration route (–1%).
Conclusions This audit revealed significant improvements in paediatric prescribing following implementation of our recommendations. However, key areas were identified for further improvement. Current work includes continued development of training, a dedicated prescribing area on the ward, regular monitoring of drug charts and continuing re-audit.