Impact of Pediatric Pharmacists Intervention in Prescription Errors Prevention among First-Year Pediatric Residents
CPS ePoster Library. Vairy S. Jun 25, 2015; 99173; 111
Stephanie Vairy
Stephanie Vairy
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Abstract
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Background: Prescription errors are a preventable cause of mortality and morbidity. Pediatric patients are particularly at risk in part because of weight-based dosing. Moreover, errors seem to correlate with the prescriber’s level of training. In July 2013, we implemented a one-month immersion program for first year residents (PGY1), which included a two-hours lecture by a pharmacist.
We hypothesized that this intervention would lead to an improvement of the prescription errors rate and quality of prescription.

Objectives: To evaluate the effect of a two-hours lecture on the rate of prescription errors and the quality of prescriptions within first-year pediatrics residents.

Methods: We conducted a retrospective study at an academic pediatric tertiary care center with approval from Institutional Review Boards. All residents included in the study provided written informed consent. The pharmacy course was given to 11 PGY1 pediatric residents (cohort 2013). We compared them to 15 PGY-1 pediatric residents not exposed to the intervention from cohort 2012 and 2013. We analyzed the 50 first prescriptions of each resident at the beginning of residence.

Results: We collected data of 1300 prescriptions (451 patients) from 26 PGY-1; 550 in the exposed group and 750 in the non-exposed group. Prescriptions proceed from patients hospitalized in general (n=804) or specialty (n=262) pediatrics wards, neonatal intensive care unit (NICU) (n=215) and emergency department (n=16). Drugs more frequently prescribed were Antibiotics and Acetaminophen/Ibuprofen.
The rate of prescription errors in the intervention group was 9.6% compared to 11.3% in the control group (p=0.32). Four prescriptions were not written in the exposed group vs. none in unexposed group (p=0.01) and error of >10% of dosage was found in 0.9% of exposed prescription’s group compared to 2.1% in unexposed (p=0.04). Six percent were errors on children younger than 3 months and 5% were in antibiotic’s prescriptions, without significant difference between groups. There was a trend toward fewer errors in dosage, frequency and route of administration in the intervention group.
Despite that no statistical difference was found between both groups in the quality of prescriptions, many mistakes were highlighted: lack of written information on charts about allergy (67.8%), dosage/weight (45.5%), generic name (28.8%), weight (26.2%), date/hour (3.6%).

Conclusion: Educational Intervention by pharmacist seems to influence positively the rate of prescription errors among junior pediatrics residents. This study also highlighted the most frequently types of prescription errors and quality mistakes that should be targeted by future interventions.
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