6ER-020 Standardisation of processes by electronic assisted prescription programme in a university paediatric hospital

Background and importance Standardisation of processes and electronic assisted prescription programmes (EAPP) are essential tools to prevent medication errors, especially relevant in vulnerable populations, such as children. Aim and objectives To standardise the processes associated with pharmaceutical prescriptions for hospitalised paediatric patients in a university hospital, through an EAPP, as a precursor to the installation of automatic dispensing cabinets. Material and methods The study was conducted in a tertiary university paediatric hospital with intensive care (ICU) and paediatric onco-haematology units (reference population 557 576 inhabitants), during the period July 2018 to June 2019. Interventions performed to ensure patient safety during EAPP implementation were: (1) meetings with professionals involved to agree on particularities/actions; (2) adaptation/validation of drug information in the EAPP to the paediatric population; (3) configuration of the EAPP login credentials; (4) training activities for nurses (all individualised sessions as required by work shifts) and doctors (group sessions to explain the tool and individualised training to prescribe); (5) protocolisation of pharmaceutical prescriptions for frequent pathologies; and (6) standardisation of intravenous infusions (fixed concentrations) for administration of drugs in the ICU. The process was conducted in areas with simple prescriptions to those with more complex prescriptions. As an initial pilot, one area maintained a double prescription system to detect weaknesses/areas of improvement. Pharmacists performed pharmaceutical validation of prescriptions and spent part of their time in the paediatric units resolving doubts/problems and detecting/correcting errors. Results Around 1500 medication sheets were reviewed/completed with dosage regimens according to weight/paediatric age group/indication, standardised administration schedules and medication alerts. Login users reviewed 50 residents, 87 doctors and 160 nurses. There were two general sessions in the hospital and eight group training sessions for doctors (1–2 per unit/medical subspecialty). Individualised training was done on demand and not counted. A total of 110 hospitalisation beds (65 general paediatrics/31 paediatric surgery/14 ICU) were included in the EAPP and 100% of prescriptions were validated by pharmacists. Twenty-two protocols were designed to standardise prescriptions, mainly in the paediatric surgery and onco-haematology areas. Eighty-two fixed concentration intravenous infusions were designed for prescription/administration of drugs in the ICU, detailing the preparation, conservation, stability, and dosage and administration regimens. Conclusion and relevance The EAPP was successfully implemented in the paediatric hospital with a high degree of standardisation and validation of pharmaceutical prescriptions, which will improve patient safety and decrease medication errors. In future studies, we intend to analyse this positive effect. References and/or acknowledgements Uptodate, Pediamecum, Micromedex, and Paediatric and Neonatal Prescription Manual-Taketomo CK Ed-18. No conflict of interest.