Aim Reported paediatric prescribing error rates are up to 13% and in our trust a baseline audit found our local error rate was 5.4%. A number of these errors are made by non paediatricians prescribing for paediatric patients. We wanted to increase their confidence in paediatric prescribing to try and reduce paediatric prescribing errors. Method We organised interactive case based teaching sessions for both the emergency medicine doctors and surgical doctors who commonly prescribe for our paediatric patients. We asked doctors to self-rate their confidence from strongly agree to strongly disagree with regards to prescribing in paediatrics. We then asked them to self-rate their confidence after the teaching session. Results Prior to the teaching sessions the majority of doctors said they either strongly disagreed or disagreed about their confidence in paediatric prescribing (25 out of 34 doctors). After the teaching sessions all doctors said they either agreed or strongly agreed that the session had increased their confidence in prescribing. Furthermore, we received many positive comments, in particular doctors appreciating the opportunity to practice prescribing for paediatric patients in an interactive environment. A repeat audit has shown a reduction in local error rate to an average of 3.4% from January to September 2018. We feel that the teaching sessions for non-paediatricians have helped to play a role with this. Conclusion Increasing confidence in paediatric prescribing for non-paediatricians is extremely important. We used interactive case studies in our teaching sessions, although we know this does not replicate seeing an actual patient, giving doctors a safe environment in which to learn in and ask questions helped improved confidence in prescribing. We feel that these teaching sessions have also helped to reduce our local error rate.Background Gastrostomy skin related stoma complications in children and young people (CYP) have negative effects and can be managed by a range of people including families, carers, special school staff, nurses and doctors. Within one educational institution we noted variations in practice, knowledge and leadership in gastrostomy problems management, this project was to explore reasons for this.No local or nationally recognised guidance were identified to help consistent management. Aims and objectives To evaluate current knowledge around gastrostomy complications and confidence of staff involved in managing these.
Aims Results from observational studies in infants with severe bronchiolitis suggest that nasal Continuous Positive Airway Pressure (nCPAP) and High Flow Nasal Cannulae Oxygen (HFNC) may improve physiological parameters and reduce respiratory distress. We aimed to examine trends in the use of headbox oxygen, CPAP and HFNC, in infants with bronchiolitis, admitted to our regional children’s hospital High Dependency Unit (HDU). Method We retrospectively reviewed electronic case records of infants aged less than one year, with a clinical diagnosis of bronchiolitis admitted to HDU between 2003 and 2013. We collected data on: age of admission, RSV-status, first modality of respiratory support used, whether the infant was transferred to Paediatric Intensive Care Unit (PICU), and length of HDU stay. In our hospital, CPAP and HFNC are only used on HDU or PICU. We excluded infants who were already in-patients with other problems and those transferred to HDU from other hospitals or after ventilation on PICU. Results Over the 10 consecutive seasons, 138 eligible infants with bronchiolitis were admitted to HDU, median age 1.5 [IQR 1,3] months; RSV was isolated in 112/138 (81%). 18/138 (13%) required subsequent admission to PICU. Trends in the use of headbox oxygen, nCPAP, HFNC, and admission rates from HDU to PICU, are shown in Figure 1. Median length of stay on HDU increased from two to four days (see Figure 1). Abstract G99(P) Figure 1 Trends in use of headbox oxygen, CPAP and HFNC in infants with bronchiolotis, admitted to High Dependency Unit. Conclusion We observed a change in the initial modality used to support infants with severe bronchiolitis on HDU from headbox oxygen, to nCPAP and HFNC. During the study period there was an initial increase in admission rates to PICU which reversed after 2006. The use of nCPAP and HFNC seemed to increase the length of stay on HDU, and we are developing decision aids to help wean infants from these therapies appropriately. Our study, which covers a longer timeframe and includes more infants than other UK studies, supports the use of CPAP and HFNC, for infants with severe bronchiolitis in a HDU setting.
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