Inadequate Training Designed To Prevent Pediatric Prescribing Errors

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Main Category: Pediatrics / Children's Health
Also Included In: Primary Care / General Practice
Article Date: 19 Jan 2008 - 0:00 PST

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Training today designed to curb the common pitfalls in pediatric drug prescribing is inadequate, according to an article published in Archives of Disease in Childhood.

These finding are a result of a trawl of published research on methods to lessen the numbers of prescribing errors and a survey a survey of relevant healthcare professionals and medicines researchers on training methods.

The authors explain than children present particular prescribing problems, because the absence of formulations designed specifically for them means that dosages have to be individually calculated, raising the chances of error.

The consequences of a mistake have a bigger impact on children than adults.

Prior research also suggests that junior doctors often feel inadequately trained to prescribe confidently, or don't know which drugs to prescribe for conditions, such as chest infections or life threatening allergic reaction (anaphylaxis).

The researchers did not find much published research on either the teaching of prescribing skills or the ways in which competencies are assessed - they report that only two relevant studies were found.

These two studies showed that the error rate dropped after particular techniques were introduced, but it was impossible to tell from the conclusions which had proved most effective.

319 out of a total of 559 questionnaires were returned for the survey, giving a response rate of 57%.

The responses showed that training in how to avoid mistakes in prescribing medicines for children was brief and predominantly in lecture format. There was little practical, hands on training.

Eleven centers taught how to complete a drug chart, while seven discussed common prescribing errors. And one centre provided a computer based prescribing course on how to calculate drug doses correctly.

However, in 13 centres training took the form of a presentation by specialist pharmacists, lasting between 30 and 60 minutes, mostly at induction. And 10 centres gave trainees an induction pack containing written information.

Just three centers tested prescribing competency, using workbooks, questions during lectures, or formal testing.

The researchers acknowledge that their research may not reflect a complete picture of prescribing training, but there is currently no validated method of assessment, nor any national standards on the teaching of prescribing medicines for children, they say.

And they suggest that at the very least it is important to find out which teaching methods work best to reduce errors, if indeed any are effective.

"Educational interventions to reduce prescribing errors"
Sharon Conroy, Clare North, Thomas Fox, Linda Haines, Claire Planner, Ian Chi Kei Wong and Helen Sammons
Arch Dis Child. Published Online First: 15 January 2008. doi:10.1136/adc.2007.127761
Click here to view abstract online

Written by - Christian Nordqvist
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