scholarly journals Pharmacists’ Approach to Optimise Safe Medication Use in Paediatric Patients

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 180
Author(s):  
Nicole Keuler ◽  
Annatjie Bouwer ◽  
Renier Coetzee

Paediatric patients are unique, yet challenging patients to care for by pharmacists. Paediatric medicine use requires special consideration. Pharmacists play an important role in educating and counselling patients, carers, and healthcare workers. Further, pharmacists have the necessary knowledge and skills to optimise safe medicine use in paediatric patients. This article provides basic principles for safe practices in paediatric medicine by following the nine rights of medication administration.

2020 ◽  
Vol 105 (9) ◽  
pp. e10.2-e11
Author(s):  
Dania Dahmash ◽  
Chi Huynh ◽  
Daniel Kirby ◽  
David Terry

AimTo identify issues encountered by pharmacy healthcare professionals with regards to problems that they have experienced, complaints received, queries and feedback by the patients or parents or caregivers in terms of medication administration for children and young people aged 0 to18 years old.MethodAn online survey using the Online Surveys tool was devised to obtain healthcare professionals’ perspective regarding medication administration problems encountered by parents, caregivers or paediatric patients when administering or taking their medication at home. The survey was sent to the members of the Neonatal and Paediatric Pharmacists Group (NPPG), who represent different geographical areas within the UK and further afield. Informed consent was obtained from participants. This study was reviewed and approved by the Life and Health Sciences Ethics Committee, Aston University.Results37 pharmacists and 1 technician completed the survey. The majority of the respondents 23/38 were currently practicing in England, with 6/38 respondents being registered pharmacists outside the UK, 1/38 was practicing in Northern Ireland, 3/38 within Scotland and 4/38 were practicing in Wales. 71.1% of the respondents strongly agreed that parents or caregivers require further training when it comes to medication delivery to their children. In addition, when asked about their concerns regarding prescribed medication to children aged between 0 to18 years old, respondents expressed a different level of concern regarding each age group. Regarding neonates, the main concern was the suitability of the prescribed formulation and the ability of the parents to accurately measure and administered a low dose volume. In contrast, for children aged between 28 days to 12 years, the common concerns were associated with palatability, which will further reflect upon child compliance and the parent or caregiver’s ability to understand medication instructions and administration. Finally, for older aged children, adherence was a common concern. Furthermore, liquid formulations (suspensions (60.5%), solutions (55.3%) and injections (44.7%)) were predominantly used among children aged 0 to 18 years old within both in and outpatients setting. Overall, the majority of the respondents expressed that counselling time between the patient and pharmacists and the need to provide further training and educational material to parents and young people is an important issue to improve understating in regards medication use.ConclusionThe findings suggest that medication administration problems occur frequently among paediatric patients, and the nature of these problems varies among each age group. Medication training for both parents and young people could be a key factor to help reduce this problem. Future research is needed to investigate and gain insight into personal experiences with medication use and administration from a parent and/or young person’s perspective. This will help to highlight the current problem in the UK and further develop potential interventions to reduce medication administration errors by parents of children aged 0 to 16 years old and by young people up to the age of 18 years.


2020 ◽  
Author(s):  
Yizhao Ni ◽  
Todd Lingren ◽  
Hannah Huth ◽  
Kristen Timmons ◽  
Krisin Melton ◽  
...  

BACKGROUND At present, electronic health records (EHRs) are the central focus of clinical informatics given their role as the primary source of clinical data. Despite their granularity, the EHR data heavily rely on manual input and are prone to human errors. Many other sources of data exist in the clinical setting, including digital medical devices such as smart infusion pumps. When incorporated with prescribing data from EHRs, smart pump records (SPRs) are capable of shedding light on actions that take place during the medication use process. However, harmoniz-ing the 2 sources is hindered by multiple technical challenges, and the data quality and utility of SPRs have not been fully realized. OBJECTIVE This study aims to evaluate the quality and utility of SPRs incorporated with EHR data in detecting medication administration errors. Our overarching hypothesis is that SPRs would contribute unique information in the med-ication use process, enabling more comprehensive detection of discrepancies and potential errors in medication administration. METHODS We evaluated the medication use process of 9 high-risk medications for patients admitted to the neonatal inten-sive care unit during a 1-year period. An automated algorithm was developed to align SPRs with their medica-tion orders in the EHRs using patient ID, medication name, and timestamp. The aligned data were manually re-viewed by a clinical research coordinator and 2 pediatric physicians to identify discrepancies in medication ad-ministration. The data quality of SPRs was assessed with the proportion of information that was linked to valid EHR orders. To evaluate their utility, we compared the frequency and severity of discrepancies captured by the SPR and EHR data, respectively. A novel concordance assessment was also developed to understand the detec-tion power and capabilities of SPR and EHR data. RESULTS Approximately 70% of the SPRs contained valid patient IDs and medication names, making them feasible for data integration. After combining the 2 sources, the investigative team reviewed 2307 medication orders with 10,575 medication administration records (MARs) and 23,397 SPRs. A total of 321 MAR and 682 SPR dis-crepancies were identified, with vasopressors showing the highest discrepancy rates, followed by narcotics and total parenteral nutrition. Compared with EHR MARs, substantial dosing discrepancies were more commonly detectable using the SPRs. The concordance analysis showed little overlap between MAR and SPR discrepan-cies, with most discrepancies captured by the SPR data. CONCLUSIONS We integrated smart infusion pump information with EHR data to analyze the most error-prone phases of the medication lifecycle. The findings suggested that SPRs could be a more reliable data source for medication error detection. Ultimately, it is imperative to integrate SPR information with EHR data to fully detect and mitigate medication administration errors in the clinical setting.


2013 ◽  
Vol 6 (3) ◽  
pp. 161-170 ◽  
Author(s):  
Heather M. Young ◽  
Suzanne K. Sikma ◽  
Susan C. Reinhard ◽  
Wayne C. McCormick ◽  
Juliana C. Cartwright

2020 ◽  
Vol 35 (9) ◽  
pp. 388-393
Author(s):  
Demetra Antimisiaris ◽  
Kristina Niehoff

In this case, a 93-year-old woman declines rapidly following glossectomy surgery and experiences rapid weight loss. She becomes withdrawn and uncommunicative and is diagnosed as failure to thrive and potentially cognitively impaired. The eventual explanation for her decline is unexpected, surprising—and counterintuitive. This case illustrates the importance of investigating every aspect of medication use related to outcomes including medication administration, therapeutics, and health system dynamics.


2009 ◽  
Vol 62 (2) ◽  
Author(s):  
Julie Greenall ◽  
Pauline Santora ◽  
Christine Koczmara ◽  
Sylvia Hyland

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