Abstract:
AIM:In paediatrics drugs are prescribed as mg/kg doses to facilitate accurate dosing. Anecdotally, some drugs are prescribed in such a way that the volume to be given is difficult to measure which may lead to inaccuracies and potential for error. Locally, errors have been reported where there has been a misunderstanding of the required dose, especially when decimal points are involved. This audit aimed to evaluate doses prescribed for in-patient children and evaluate whether they can be measured using the printed markings of one oral syringe. METHOD:Data were collected for paediatric in-patients between 16th February and 27th March 2015 from paper drug charts and an electronic prescribing system depending which was in use in each area. Specific data on patient age, weight and prescribed dose were collected. Volumes were then calculated using the enteral products kept in the Trust formulary, including unlicensed specials. The prescribed volumes were reviewed against the Medicina Home® enteral syringes to see if they were measurable on the printed graduations of one oral syringe (in line with local dispensing standards). If they could not be measured, the percentage dose rounding required was calculated to see if doses could be rounded. A judgement was then made as to whether this was within an acceptable safe dose limit. RESULTS:Data for 560 individual medication orders for oral medicine were collected, 257 from electronic prescribing and 303 from paper charts. Of these 457 were liquid doses, 103 were from products only available as tablets or capsules. Of the 257 electronically prescribed doses, 61 (24%) were not measurable. Of the 303 paper chart doses, 57 (19%) were not measurable.Of the 457 liquid doses 77 only needed up to 4% dose adjustment to become measurable. A further 10 doses required up to 9% dose adjustment.Drugs that were frequently prescribed as non-measurable doses were: diazepam, alimemazine, chloral hydrate, azithromycin, metronidazole, paracetamol & ibuprofen.Some doses were not measurable from tablets and no liquid is available in the Trust: clonidine, omeprazole, lansoprazole, nifedipine SR.19/560 (3.4%) of medication orders required a dose to be measured to two decimal places: diazepam, morphine, clonazepam, furosemide, spironolactone, chloral hydrate, ranitidine, chlorothiazide, azithromycin, erythromycin. CONCLUSION:This audit has shown that by prescribing accurately as mg/kg without any dose rounding almost a quarter of doses cannot be measured accurately. Only a small dose adjustment is required to make the doses measurable. The current electronic prescribing system in use does not appear to have any automatic rounding, indeed the prevalence of difficult to measure doses was slightly worse (although not statistically significant, p value 0.19, Chi squared test), possibly because the prescriber doesn't "sense check" what they are prescribing as it is automated. Particular drugs with unusual strengths are often implicated in having harder to measure doses. Consideration should be made to round doses when prescribing and to add information regarding the strength of liquids available in local clinical guidelines.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Balsara J,Fletcher Pdoi
10.1136/archdischild-2016-311535.21subject
Has Abstractpub_date
2016-09-01 00:00:00pages
e2issue
9eissn
0003-9888issn
1468-2044pii
archdischild-2016-311535.21journal_volume
101pub_type
杂志文章abstract:AIMS:The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies: the asthma/rhinitis care pathway is the third such pathway. Asthma and rhinitis have been considered together. These ...
journal_title:Archives of disease in childhood
pub_type: 共识发展会议,杂志文章
doi:10.1136/adc.2011.213462
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To determine if administration of oral prednisolone to preschool children with acute wheeze alters respiratory outcomes. DESIGN:Double-blind, randomised, placebo-controlled equivalence trial. SETTING:Three hospitals in New Zealand. PATIENTS:477 children aged 24-59 months with acute wheeze associated with r...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2020-318971
更新日期:2020-10-16 00:00:00
abstract::Ninety seven teachers of diabetic pupils in Liverpool completed a questionnaire designed to assess their knowledge of diabetes mellitus and the sources from which they had obtained information. The survey aimed to evaluate their understanding and to aid in planning an alternative policy of teacher education. Only 24 t...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.58.9.692
更新日期:1983-09-01 00:00:00
abstract::An infant with lactose intolerance is described. A breast-fed infant developed vomiting at 3 weeks, and became dehydrated. Lactosuria, aminoaciduria, and liver damage were preesent. A milk-free diet led to rapid recovery. At 6 months a normal diet was well tolerated. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.4.304
更新日期:1980-04-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between ethnicity and health outcomes among fetuses and infants with congenital left heart obstruction (LHO). DESIGN:A retrospective population-based review was conducted of fetuses and infants with LHO including all terminations, stillbirths and live births from 20 weeks' ges...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2018-315887
更新日期:2019-09-01 00:00:00
abstract:AIMS:To evaluate the clinical efficacy of sublingual immunotherapy (SLIT) in respiratory allergy in children. METHODS:A systematic literature review was conducted. The search was focused on all the double blind (and double dummy if necessary) studies. SEARCH STRATEGY:Medline, Embase, Cochrane Controlled Trial Registe...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2003.030411
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVES:To examine the role of viruses in febrile seizures (FS) by comparing the relative risk (RR) of developing FS with common viral infections and subsequent risk of recurrence. METHODS:We matched the medical records of all children admitted with FS over 5 years and the contemporary records for all admissions fo...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.110221
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:To develop and validate a new allergy-specific patient-reported experience measure (PREM) for children and their parents, and to collect feedback in an integrated care setting. DESIGN:Two allergy-specific PREMs were produced using focus groups, cognitive testing, two prospective validation studies (collabor...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2015-309598
更新日期:2016-10-01 00:00:00
abstract::To study maternal and fetal influences on blood pressure in childhood 405 children aged 4 years who were born and still resident in the Salisbury health district were visited at home for blood pressure and growth measurements. Information on the pregnancy, delivery, and baby was abstracted from the routine obstetric n...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.11.1291
更新日期:1991-11-01 00:00:00
abstract::Urinary lithogenic and inhibitory factors were studied in 27 preterm infants; 16 had total parenteral nutrition (TPN) and 11 had breastmilk with an additional glucose-sodium chloride infusion. Urines were collected for 24 hours on day 2 (period A), day 3 (B), and once between days 4 and 10 (C). Urinary calcium oxalate...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.69.3_spec_no.299
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Studies on adolescent drug use are scarce as most studies do not distinguish between children and adolescents. Therefore, we assessed overall drug use in adolescents. METHODS:A retrospective cohort study was conducted using pharmacy dispensing records from 62 community pharmacies in the Netherlands. Dispens...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2017-314692
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Wiskott-Aldrich syndrome (WAS) is an X-linked primary immunodeficiency caused by a mutation of the WAS protein gene. This protein actively participates in important cellular processes, and its presence is related to diverse clinical manifestations, including cutaneous alterations. The classical triad of WA...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2011-300812
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children. DESIGN:Randomised, double blind, placebo controlled crossover trial, with two 2-week treatment periods separated by a 2-week placebo washout. SETTING:Six UK paediat...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/adc.2006.115493
更新日期:2007-11-01 00:00:00
abstract::Information is presented about 19 children, under age 7 years, from 17 families, whose mothers consistently gave fraudulent clinical histories and fabricated signs so causing them needless harmful medical investigations, hospital admissions, and treatment over periods of time ranging from a few months to 4 years. Epis...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.57.2.92
更新日期:1982-02-01 00:00:00
abstract::A picture archiving and communication system (PACS) is a computerised means of replacing the roles of conventional radiological film. This review describes the Hammersmith PACS, and discusses the advantages and disadvantages of PACS systems. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.83.1.82
更新日期:2000-07-01 00:00:00
abstract::In acute paediatrics, overtreatment and overdiagnosis is encountered in threshold and developed countries. The reason for overtreatment may be similar in the two settings, namely the mere availability of invasive procedures, which may lead to their inappropriate use. Physiological healing processes should be integrate...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2007.124479
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To describe the significance of pericardial effusion (PE), mitral regurgitation (MR) and impaired systolic function in predicting coronary artery lesions (CAL) at diagnosis and follow-up in Kawasaki disease (KD). DESIGN:Echocardiographic records on admission, at 1-3 weeks of illness, and at 6-8 weeks of illn...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2011-301256
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:In cystic fibrosis (CF), problems with sleep, eating/mealtime behaviours, physiotherapy adherence and parental mental health issues are common, yet their natural history and the extent of service use to address them are unknown. OBJECTIVE:Follow up the 2007 cohort to determine: (1) prevalence of child sleep...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,多中心研究
doi:10.1136/archdischild-2011-301527
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Mauriac syndrome is characterised by growth failure, cushingoid appearance and hepatomegaly which occurs in patients with insulin dependent diabetes and was first described shortly after the introduction of insulin as a treatment for the condition. OBJECTIVE:To describe the clinical features, histological f...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2013-304426
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Sodium phenylbutyrate (NaPB) is used as a treatment for urea cycle disorders (UCD). However, the available, licensed granule form has an extremely bad taste, which can compromise compliance and metabolic control. OBJECTIVES:A new, taste-masked, coated-granule formulation (Luc 01) under development was chara...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2012-302398
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:It is often assumed that prolonged time to diagnosis (TTD) for cancer negatively influences overall survival and survivorship through advanced stage disease at diagnosis. This systematic review assesses existing early diagnosis research in childhood and young adult cancer and aims to identify whether a consensu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/archdischild-2012-303034
更新日期:2013-05-01 00:00:00
abstract::Interferon is becoming the standard treatment in adults for chronic hepatitis C. Twenty one children with histologically proved chronic hepatitis C (10 boys, range 2.5-13 years), who were otherwise healthy, were enrolled in a randomised controlled study to test their response to interferon alfa. Eleven children were t...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.74.2.152
更新日期:1996-02-01 00:00:00
abstract::The aim of this study was to determine whether doctors recognise eating disorders in children, in particular anorexia nervosa. A group of paediatricians, general practitioners, and school medical officers was approached to participate in the study. Each was sent a questionnaire including two case vignettes of children...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.67.1.103
更新日期:1992-01-01 00:00:00
abstract::Blood pressure (BP) values and the phenomenon of tracking were evaluated in a group of 481 schoolchildren over a nine year period starting at age 6 years. BP values were obtained yearly by taking the mean of two measurements at one visit, measurements were taken by only two observers during the study. For both systoli...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.81.2.169
更新日期:1999-08-01 00:00:00
abstract::This report highlights the association between tuberous sclerosis and Wolff-Parkinson-White syndrome. Ten patients with concurrent diagnoses of Wolff-Parkinson-White syndrome and tuberous sclerosis were identified. Wolff-Parkinson-White syndrome presented early in life, nine cases being diagnosed in the first year. Ei...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.78.2.159
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Cerebral palsy is the commonest cause of severe physical disability in childhood. For many years treatment has centred on the use of physiotherapy and orthotics to overcome the problems of leg spasticity, which interferes with walking and can lead to limb deformity. Intramuscular botulinum toxin (BT-A) offer...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/adc.83.6.481
更新日期:2000-12-01 00:00:00
abstract::Fifty-one children with a bacteriologically proven urinary tract infection had both an intravenous urogram (IVU) and a micturating cystogram. The IVU was normal in 35. Only 6 of these children showed reflux in the cystogram, affecting 7 of the 70 ureters at risk. Since reflux on its own does not cause renal damage, wh...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.11.893
更新日期:1976-11-01 00:00:00
abstract::Ketamine hydrochloride 2 mg/kg, together with atropine 0.2 mg, has been given intravenously on 100 occasions on a general paediatric ward. No serious side effects occurred. Dreams followed in 4 children but did not reduce acceptability of the drug. In our hands it has greatly reduced the pain and distress of children ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.1.56
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Most children with daytime wetting have detrusor instability. A minority have neuropathic vesicourethral dysfunction. The commonest cause is spina bifida, which may be closed. Clinical features suggestive of closed spina bifida include cutaneous, neuro-orthopaedic or lumbosacral spine x ray abnormalities, im...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.87.2.151
更新日期:2002-08-01 00:00:00
abstract::A significant proportion of children with anorectal malformations have long term problems with faecal continence. The psychological consequences of this chronic disability was assessed in 160 children and adolescents. The prevalence of clinically significant emotional problems among the sample overall, as assessed by ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.71.3.194
更新日期:1994-09-01 00:00:00