For children admitted to hospital, what interventions improve medication safety on ward rounds? A systematic review

Abstract

ObjectiveEvery year, medication errors harm children in hospitals. Ward rounds are a unique opportunity to bring information together and plan management. There is a need to understand what strategies can improve medication safety on ward rounds. We systematically reviewed published interventions to improve prescribing and safety of medicines on ward rounds.DesignSystematic review of randomised controlled trials and observational studies.SettingStudies examining inpatient ward rounds.PatientsChildren and young people aged between 0 and 18 years old.InterventionsAny intervention or combination of interventions implemented that alters how paediatric ward rounds review inpatient medications.Main outcome measurePrimary outcome was improvement in medication safety on paediatric ward rounds. This included reduction in prescribing error rates, healthcare professionals’ opinions on prescribing and improvement in documentation on ward rounds.ResultsThree studies were eligible for review. One examined the use of an acrostic, one the use of a checklist, and the other a use of a specific prescribing ward round involving a clinical pharmacist and doctor. None of the papers considered weight-based errors or demonstrated reductions in clinical harm. Reductions in prescribing errors were noted by the different interventions.ConclusionsThere are limited data on interventions to improve medication safety in paediatric ward rounds, with all published data being small scale, either quality improvement or audits, and locally derived/delivered. Good-quality interventional or robust quality improvement studies are required to improve medication safety on ward rounds.PROSPERO registration numberCRD42022340201.