Impact of a Process Change on Prevalence of Prescribed Unmeasurable Liquid Doses in a Neonatal Intensive Care Unit
| Autor: | Todd Foster, Jamalyn N Casey, Liz Hess, Amanda J Place, Jennifer Tobison, Stephanie O Zahn |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit business.industry Clinical Investigations Processes of change law.invention 03 medical and health sciences Patient safety 0302 clinical medicine Calculator law Electronic health record 030225 pediatrics Electronic prescribing Pediatrics Perinatology and Child Health Emergency medicine Medicine Pharmacology (medical) 030212 general & internal medicine Dosing business Hospital use |
| Zdroj: | The Journal of Pediatric Pharmacology and Therapeutics. 25:96-103 |
| ISSN: | 1551-6776 |
| DOI: | 10.5863/1551-6776-25.2.96 |
| Popis: | OBJECTIVESMost prescribing through the electronic health record (EHR) in the NICU at St. Vincent Women's Hospital use a weight-based dosing calculator. Prescribers receive no alert if the resulting volume is unmeasurable. Study definition of measurable was a dose volume with a visible hash mark on an appropriately sized oral syringe. The primary objective was to compare the rate of unmeasurable oral liquid doses prescribed at discharge before and after implementation of educational process changes. Secondary objectives assessed patient and discharge medication characteristics in relation to the unmeasurable doses prescribed.METHODSThis study was a 2-phase retrospective analysis of patients discharged from the NICU between January 1 and June 30, 2016 (phase I), and between October 1, 2017, and March 31, 2018 (phase II). Patients were included in the analysis if they were discharged on at least 1 oral liquid medication, excluding vitamins. Demographic and discharge medication information was collected.RESULTSThere were 58 patients discharged on a total of 118 oral liquid medications in phase I and 63 patients discharged on a total of 111 oral liquid medications in phase II. Following implementation of the process change, the percentage of unmeasurable discharge prescriptions decreased from 27 (23%) to 5 (4.5%) (p < 0.001).CONCLUSIONSThe educational process change implemented in the NICU effectively reduced the rate of unmeasurable doses prescribed at discharge from 1 in 4 to 1 in 25. Additional system-level changes may result in further reductions. |
| Databáze: | OpenAIRE |
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