Drug Topics - May 12, 2008 - (Page 12)

12 DRUG TOPICS MAY 12, 2008 www.drugtopics.com > > >Latebreakers… In Depth R.Ph.s say more needs to be done to prevent pediatric drug errors Anthony Vecchione ealth-system pharmacists Drug Topics, May 22, 2006). responded favorably to a reUnder the category of full pharmacent Joint Commission (JC) cy oversight, the JC recommends the Sentinel Event Alert that addressed development of preprinted medication the problem of pediatric medication order forms and clinical pathways or errors. But some pharmacists admit protocols to reflect a standardized that there’s a long way to go before approach to care. Hilmas said that medications made for adults and preprinted medication order forms administered to children will be a are critical because there will be a thing of the past. huge push toward computerized phyThe JC alert recommended pedisician order entry (CPOE). “Having atric-specific strategies for reducing these things in place now will ensure medication errors including paypatient safety for pediatric patients ing greater attention to precautions and then help when they transition such as medication standardization, Elora Hilmas says that for years to CPOE.” improved medication identification pharmacists have been wary The JC alert also urges hospitals about the labeling of heparin and communication techniques, and vials. to use technology judiciously. “Smart the adoption of kilograms as the pumps are the last level of check bestandard weight measurement to calculate dosages. fore a medication is infused. If the drug library is not The Joint Commission lists other risk reduction strat- built properly, you are not getting the true benefits of egies at www.jointcommission.org. a smart pump. It has to be built with the appropriate “This alert calls for hospitals to weigh the pediatric safeguards and be used properly by nurses.” patients in kilograms and this should become the At Swedish Medical Center in Seattle, the focus on standard for reporting pediatric patient weight,” said pediatric training extends beyond pharmacists and Peter Angood, M.D., VP and chief patient safety of- nurses to pharmacy technicians. “At Swedish we have ficer at the JC at a press conference last month. a subset of pharmacy technicians who are specifically In the alert, the JC cited a U.S. Pharmacopeia sur- trained in pediatrics. They are very cognizant of what vey revealing that most of the harmful pediatric errors pediatric errors might occur,” said Nancy Nugent, over the past two years involved either an improper R.Ph., a pediatric pharmacist at Swedish Hospital. dose or quantity. The alert noted that problems typiHealth-system pharmacists, especially those who cally happen when hospitals and clinics are forced to work in children’s hospitals or in facilities with a prepare special volumes or concentrations because sizable pediatric patient population, assert that they drugs are formulated and packaged for adults. In have been trying for years to push through some of order to prepare these drugs for children, the original the safeguards outlined in the JC’s alert. Some pharmedication dosage requires a series of calculations and macists complain that it often takes a high-profile tasks that increase the chance for an error to occur. pediatric medication error before the public is made Some hospitals are turning to technology as a way aware of the extent of the problem, such as the acof addressing the issue of standardized concentrations. cidental overdose of the blood thinner heparin for Elora Hilmas, Pharm.D., pharmacy residency coordi- actor Dennis Quaid’s twin infants. “For years we nator at the Alfred I. DuPont Hospital for Children in have been complaining about the labeling of heparin Wilmington, Del., is one of the patent holders for Phar- vials because they look so similar. Hopefully now a macy OneSource’s Accupedia, which optimizes accurate change will take place,” said Hilmas. “I think with pediatric drips based upon standardized concentrations technology and CPOE and safety checks to help with and fluid loads. The software program allows users to medication calculations, we are going to make a lot order continuous infusion without using an antiquated more progress in the future.” Rule of 6 method of determining concentrations (see THE AUTHOR is a writer based in New Jersey. H http://www.drugtopics.com http://www.jointcommission.org

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Drug Topics - May 12, 2008 Contents Latebreakers Letters R.Ph.s Say More Needs to be Done to Prevent Pediatric Drug Errors There's a New School of Thought on Use of Beta-Blockers for Hypertension Cover Story Guest Spot Letters Clinical Practice Special Report Professional Practice Broad Label for New Leukemia Therapy Looks Promising Treating Asthma During Pregnancy Safer than Not, Says New Guide In the Pipeline Clinical Q&A APhA Leader's Plan to Leave Office Takes Center Stage at its Conference Policies Passed at a Glance Giving a Talk to the Community? Check Out These Materials This Foundation has Funds to Spare JP at Large Cover Story: Employers and R.Ph.S: A Win-Win Combo FDA's Ilisa Bernstein Discusses Pharmacy Affairs Legal Q&A Manufacturers Unleash a Rash of Poison Ivy Treatments Are OTC Cold Remedies Safe for Kids? Probiotics are All the Rage: How You Can Capitalize on It CMS' Prices for Round One of DMEPOS Competitive Bidding Raising Concerns CVS Caremark's Mentoring Program Recruits and Retains R.Ph.s Antibiotic Resistance Among Community Pathogens Technology Update New Products Advertisers Index Classified Viewpoint

Drug Topics - May 12, 2008

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