AimMedical students have a paediatric placement during their 4th year of medical school. Paediatric pharmacists are involved with teaching sessions to the medical students, including one on prescribing. The overall aim of this audit is to evaluate this teaching on prescribing delivered by the paediatric pharmacist to determine the impact pharmacist has. Specific aims are to: increase the confidence of the medical students in their prescribing; increase their competence in prescribing different medications on a kardex; and determine what extent of prescribing teaching they currently receive. The aim is to collect data for all the students that come for their paediatric placement throughout the academic year (September 2021 – June 2022).MethodPrior to the teaching session the medical students were given a questionnaire to complete with questions including how confident they felt in prescribing, how much training they have previously received in prescribing, and a number of different scenarios with medications to prescribe. They then received a teaching session including a practical session of prescribing on kardexes. Following this session, a questionnaire was completed by the medical students asking again about their confidence in prescribing, the different medications to prescribe again, and overall comments on the session.ResultsThe questionnaire was initially trialled on the first set of students in September 2021 and following this, changes were made to the questionnaire. The data from this group was therefore excluded from the results and analysis.Data was analysed from the questionnaires of 33 students. Before the teaching session, 94% of the students were either ‘Not at all confident’ or ‘Slightly confident’ in prescribing for paediatric patients on an inpatient kardex. Following the session this percentage fell to 9% of the students. Instead, 91% of the students stated they were either ‘Somewhat confident’ or ‘Fairly confident’. The questionnaire contained 5 different medications to be prescribed on a kardex template including gentamicin, Clenil®, prednisolone, Epilim® and paracetamol. In the gentamicin scenario, only 3% of students got it completely correct before the teaching session compared to 21% after the teaching. In the Clenil® scenario, 82% of the students were incorrect, compared to after teaching when only 3% were incorrect, with the remainder being partially or completely correct. When prescribing prednisolone, 48% of the students prescribed it incorrectly before the teaching, with none of the students completing all prescribing elements correctly. After the teaching, only 3% were incorrect, with the majority partially correct and 27% completely correct. In the paracetamol prescription, only 3% of students got this totally correct before teaching with 76% of them completing all prescribing elements correctly after the teaching. In the final scenario on Epilim®, 52% of students were incorrect in their prescription compared to only 6% after the teaching.ConclusionThe data shows that the medical students’ confidence in prescribing increased following the teaching session. In each of the prescribing scenarios they completed, the accuracy in these increased in all 5 scenarios. The paracetamol scenario showed the greatest improvement of all the scenarios.
AimTo determine the efficiency of dispensing paediatric discharges at dispensary vs ward level.MethodA data collection form was designed for use during a two-phase audit. During the first week of data collection, the turnaround time of dispensing discharges in the dispensary was collected. In the second week, the turnaround time of dispensing discharges at ward level on the paediatric ward was recorded.The dispensary standard of a 60 min turnaround for medium priority discharges1 was used for both weeks. Medical, surgical and ENT prescriptions were all included in the audit.ResultsInformation relating to 23 discharges was collected during week one at dispensary level. In week 2, 21 discharges were assessed.When assessing the minimum and maximum time taken from when a patient was informed of their discharge to medications being given, there was a reduction of 98 min when completed at ward level for minimum time and 75 min for the maximum time.The average turnaround time for dispensing prescriptions was 94 min at dispensary level and 26 min at ward level. Only 57% of discharges completed in the dispensary met the standard turnaround time of 60 min compared to 100% completed at ward level. Discharge prescription turnaround time was decreased by 72% when completed at ward level.In total sixteen discharge steps were identified using the traditional dispensary based method for discharges. These ranged from the patient being told they can go home on the ward round to the prescription being written and sent to pharmacy, and finally returned to the ward for transfer to the patient.The process of dispensing discharges at ward level enabled a reduction of 50% of the sixteen steps, subsequently expediting the discharge process.ConclusionWhen discharges were completed at ward level standards were met 100% of the time and a reduction in eight discharge steps was accomplished. Thus highlighting that a ward level dispensing service is necessary on the paediatric ward in this District General Hospital.ReferenceWallace K. Prescription Tracker System (PTS). Patient services District General Hospital2014.
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