Dietary supplements: inpatient policies in US children's hospitals.
BACKGROUND
Variations in hospital policies and practices regarding the use of vitamins, minerals, herbs, and other dietary supplements could compromise patient safety and quality of care. We undertook this study to describe pediatric hospital policies regarding dietary supplements.


METHODS
We administered a cross-sectional survey of a sample of National Association of Children Hospitals and Related Institutions members. Pharmacy personnel were asked about the following: written policies addressing dietary supplements; how such policies are made; and responsibilities for storage, administration, documentation, and checking for potential interactions. We created a 10-point hospital policy and practices quality score to assess the quality of each policy.


RESULTS
Of the 186 eligible National Association of Children Hospitals and Related Institutions hospitals, 109 responded (59%). Forty-four percent reported having written policies on vitamins and minerals, herbs, and other dietary supplements. Few hospitals had herbs (2%) or other dietary supplements (38%) on formulary. However, most (81%) allowed patients to use their home supply of dietary supplements under defined circumstances, and 64% allowed staff to make recommendations about dietary supplement use. In 70% of hospitals, nurses stored and administered the home supply of dietary supplements. Less than half (46%) required documentation of a check for drug or dietary supplements interactions. One third (32%) had surgical preoperative recommendations regarding dietary supplements. Only 11% of 109 hospitals satisfied the 10 criteria necessary for a perfect hospital policy and practices quality score indicative of quality practices regarding patient use of dietary supplements.


CONCLUSIONS
Even among those hospitals that have written policies about dietary supplements, there is a wide range in policy quality, which may compromise the safety of patients.
Gardiner
Paula
P
Osher Institute, Harvard Medical School, Boston, Massachusetts, USA. paula_gardiner@hms.harvard.edu
Phillips
Russell S
RS
Kemper
Kathi J
KJ
Legedza
Anna
A
Henlon
Silas
S
Woolf
Alan D
AD
D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007297:Inpatients; D008297:Male; D018673:Nutrition Policy; D016134:Organizational Policy; D010607:Pharmacy Service, Hospital; D011050:Policy Making; D017751:Safety Management; D014481:United States