Use of Standardized Dosing Sheets in Pediatric Emergency Care: Experience in a Third-Level Hospital

Abstract

Objectives:

Medication errors are one of the main causes of avoidable injuries in health care. With the aim of reducing them, a set of sheets with precalculated doses (by weight intervals) and preparation guidelines of the most common drugs in emergencies (Farmacards) was implemented in a Pediatric Emergency Department, replacing the previous manual calculation system. The aim of the study is to assess the staff’s perception of safety and usefulness of the new dosing system.

Study design:

Pre-post intervention comparative analysis was performed by distributing an opinion questionnaire to pediatric emergency department staff in 2017 (manual calculation in situ) and 2023 (Farmacards). We obtained 60 and 55 responses, respectively, and analyzed the characteristics of the sample and the perception of the new method.

Results:

Five years after its introduction, 88.5% were aware of its existence, 86.9% knew where to find it, and 76% used it “always or almost always” for critically ill patients. Greater use was observed among personnel with more years of work experience (Spearman, P = .057) and among nurses (Mann-Whitney, P < .001). The new method improved the level of perceived safety, especially for nurses (Mann-Whitney, P = .008).

Conclusions:

Standardized medication dosing systems in emergency situations aim to reduce medical errors and minimize iatrogenesis, participating in safety culture. According to the results of our study, the implementation of Farmacards shows a good acceptance by the staff and in the perception of patient safety, which is a good starting point to further optimize the quality of care. specialties: emergency medicine, general pediatrics, toxicology, and critical care.