title: Profile of prescribing errors detected by clinical pharmacists in paediatric hospitals in Spain.
abstract: BACKGROUND
  Pharmaceutical care involves three essential functions: identifying potential and real medication-related problems, solving real medication-related problems and preventing potential medication related problems.
  
  
  OBJECTIVE
  To describe the profile of prescribing errors detected and prevented by paediatric clinical pharmacists in medical orders for inpatients in Spain.
  
  
  METHODS
  A prospective, descriptive, multicentre epidemiological study on medical orders for inpatients aged 1 day to 18 years, conducted between July and October 2011 at eight hospitals treating paediatric patients.
  
  
  METHODS
  primary variables were most common errors, including clinical severity (according to a previously validated instrument), pharmacotherapeutic groups and drugs most commonly involved, the impact of pharmaceutical interventions, as well as the population receiving most interventions, and type of prescription (manual of electronic) and dispensation system (ward stock, unit-dose or automated dispensing cabinets) that are most involved in Spain.
  
  
  RESULTS
  A total of 667 interventions related to quality of the prescription were recorded at eight sites. 21 were excluded. 41.2 % concerned manual prescribing systems, and 58.8 % electronic prescribing systems. The interventions were performed on patients with a mean age of 5 years (standard deviation 5.43). In interventions concerning prescribing errors, 212 different drugs were involved, mainly belonging to the group of anti-infectives. The main factor triggering pharmacist's recommendations was dose errors of 1.5-10 times the recommended dose. Therefore, the main prescription errors are dosing errors (49.3 %). With regard to the clinical severity of these prescribing errors, 51.9 % (306 cases) were considered significant, 26.3 % (155 cases) of minor significance, 19.8 (117 cases) were clinically serious and 2.0 % (12 cases) were potentially fatal. There was a 95.4 % global acceptance rate for recommendations. The impact of accepted interventions showed that 64.7 % had a significant impact on patient health outcome, highlighting 1.1 % with a highly significant impact. The activity level of the paediatric clinical pharmacists was highly variable, with a median of 0.014 interventions/bed-day during the data collection period.
  
  
  CONCLUSIONS
  In view of the importance of the dosing errors in the prescription phase, and the clinical relevance of the errors detected, it seems to be necessary to implement measures as the development of decision support systems for paediatric dosing and strengthen the presence of pharmacists as a key element in preventing prescribing errors from reaching patients, thus ensuring that children receive effective, safe and efficient drug therapy.
authors.affiliation: Clinical Pharmacist, Pharmacy Service, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46, 28007, Madrid, Spain. cmartinezf.hgugm@salud.madrid.org
authors.forename: Cecilia M
authors.initials: CM
authors.lastname: Fernández-Llamazares
authors.forename: Maite
authors.initials: M
authors.lastname: Pozas
authors.forename: Begoña
authors.initials: B
authors.lastname: Feal
authors.forename: M Josep
authors.initials: MJ
authors.lastname: Cabañas
authors.forename: Miquel
authors.initials: M
authors.lastname: Villaronga
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Hernández-Gago
authors.forename: Mercedes
authors.initials: M
authors.lastname: Ruiz de Villegas
authors.forename: Concha
authors.initials: C
authors.lastname: Álvarez-del-Vayo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008508:Medication Errors / Q000706:statistics & numerical data*; D010595:Pharmacists; D010607:Pharmacy Service, Hospital; D010818:Practice Patterns, Physicians' / Q000592:standards*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain
chemical_list: D055553:Prescription Drugs