title: The use of a consultant-led ward round checklist to improve paediatric prescribing: an interrupted time series study.
abstract: A Check and Correct checklist has previously been developed to increase feedback on prescribing quality and enhance physicians' focus on patients' drug charts during ward rounds. Our objective was to assess the impact of introducing such a prescribing checklist on the quality and safety of inpatient prescribing in two paediatric wards in a London teaching hospital. Between 15 March 2011 and 15 May 2011 (pre-intervention) and between 23 May 2011 and 23 July 2011 (post-intervention), we recorded rates of both technical prescription writing errors and clinical prescribing errors twice a week. During the pre-intervention period, the overall technical error rate was 10.8 % (95 % confidence interval 10.3 %-11.2 %); the clinical error rate was 4.7 % (3.4 %-6.6 %). The most common errors were absence of prescriber's contact details and dose omissions. After the implementation of Check and Correct, error rates were 7.3 % (6.9 %-7.8 %) and 5.5 % (3.9 %-7.9 %), respectively. Segmented regression analysis revealed a significant decrease of -5.0 % in the technical error rate (-7.1 to -2.9 %; -37.7 % relative decrease; R (2) = 0.604) following the intervention, independent of changes in overall medical records' documentation quality. Regarding clinical errors, no significant impact of the intervention could be detected.
  
  
  CONCLUSIONS
  Implementing a Check and Correct checklist led to an improvement in the quality of prescription writing. Although a change in culture may be needed to maximise its potential, we would recommend its more widespread use and evaluation.
authors.affiliation: Sciences du Risque dans le domaine de la Santé, Faculté de Pharmacie, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Lépée
authors.forename: Robert E
authors.initials: RE
authors.lastname: Klaber
authors.forename: Jonathan
authors.initials: J
authors.lastname: Benn
authors.forename: Penny J
authors.initials: PJ
authors.lastname: Fletcher
authors.forename: Pieter-Jan
authors.initials: PJ
authors.lastname: Cortoos
authors.forename: Ann
authors.initials: A
authors.lastname: Jacklin
authors.forename: Bryony Dean
authors.initials: BD
authors.lastname: Franklin
mesh_terms: D057189:Checklist; D002648:Child; D004282:Documentation / Q000592:standards; D011307:Drug Prescriptions / Q000592:standards*; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008131:London; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D061214:Patient Safety; D010372:Pediatrics / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration; D012044:Regression Analysis; D013997:Time Factors