Objective Every year, medication errors harm children in hospitals. Ward rounds are a unique opportunity to bring information together and plan management. There is a need to understand what strategies can improve medication safety on ward rounds. We systematically reviewed published interventions to improve prescribing and safety of medicines on ward rounds.

Design Systematic review of randomised controlled trials and observational studies.

Setting Studies examining inpatient ward rounds.

Patients Children and young people aged between 0 and 18 years old.

Interventions Any intervention or combination of interventions implemented that alters how paediatric ward rounds review inpatient medications.

Main outcome measure Primary outcome was improvement in medication safety on paediatric ward rounds. This included reduction in prescribing error rates, healthcare professionals’ opinions on prescribing and improvement in documentation on ward rounds.

Results Three studies were eligible for review. One examined the use of an acrostic, one the use of a checklist, and the other a use of a specific prescribing ward round involving a clinical pharmacist and doctor. None of the papers considered weight-based errors or demonstrated reductions in clinical harm. Reductions in prescribing errors were noted by the different interventions.

Conclusions There are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds.

PROSPERO registration number CRD42022340201.