Quality improvement project to reduce paediatric prescribing errors in a teaching hospital

Abstract

A quality improvement project to reduce paediatric prescribing errors was carried out in a London teaching hospital between June 2013 and March 2014. It involved paediatric medical and surgical wards and a paediatric intensive care unit. A multi professional team of 'prescribing champions' was formed. Baseline audit identified high prescribing error rate. Prescribing standards were taught through workshops and 'prescribing test'. Feedback of weekly sampling and 'star chart game' led to an initial improvement of prescribing errors which was not sustained. Qualitative feedback showed increased knowledge and empowerment of multi-professional stakeholders.

Gamification of health professions education: a systematic review

“…Our search identified 5044 articles, of which 38 met the inclusion criteria on the basis of full-text screening. Uncertainty about inclusion or exclusion of 20 other articles (Bigdeli and Kaufman 2017;Boysen et al 2016;Campbell 1967;Courtier et al 2016;Creutzfel dt et al 2013;Dankbaar et al 2016Dankbaar et al , 2017Hudon et al 2016;Inangil 2017;Kaylor 2016;Leach et al 2016;Lim and Seet 2008;Mishori et al 2017;Montrezor 2016;Patton et al 2016;Richey Smith et al 2016;Sabri et al 2010) were resolved by consensus discussion among all members of the research team, which yielded three additional studies. Of the 17 studies excluded in this step, one was excluded because no consensus could be reached (Mullen 2018), the others did not meet the inclusion criteria.…”

Effects of Gamification on the Benefits of Student Response Systems in Learning of Human Anatomy: Three Experimental Studies

“…Gamification has been also widely employed in a variety of healthcare courses: psychiatric [ 35 ], COPD (acronym of Chronic Obstructive Pulmonary Disease) treatment [ 36 ], oncology [ 37 ], obstetrics [ 38 ], urology [ 39 ], surgery [ 40 , 41 , 42 , 43 , 44 ] emergency medicine [ 45 ], physiology [ 46 , 47 , 48 ], gynecology [ 49 ], internal medicine [ 50 ], resuscitation principles [ 51 ], anatomy [ 48 , 52 ], urine catheterization [ 53 ], radiology [ 54 ], and pediatrics [ 55 ]. The most used gamification elements in healthcare are scoring [ 37 , 38 , 39 , 41 , 42 , 45 , 46 , 50 , 52 , 53 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ] and competition [ 37 , 38 , 39 , 41 , 42 , 44 , 49 , 50 , …”

“…Rewards [ 36 , 41 , 43 , 47 , 48 , 54 , 67 , 68 , 69 ], signposting [ 36 , 62 ], and time [ 45 , 47 , 53 , 54 , 60 , 61 , 62 , 68 ] are also frequently used. Other gamification elements less employed in the teaching of health sciences are puzzles [ 35 , 70 ], role playing [ 35 , 61 , 71 , 72 ], achievements [ 73 ], missions [ 73 ], avatars [ 36 , 47 ], levels [ 36 ], quizzes [ 36 , 73 ], badges [ 50 , 56 ], levelling [ 45 , 56 , 62 , 63 ], quests [ 56 , 65 ], awards [ 40 , 74 ], teams [ 59 , 60 , 61 , 67 ], mystery characters [ 51 , 60 , 68 ], progress [ 44 ], social networks [ 44 , 58 ], and storytellings [ 65 ]. Certainly, game elements motivate and attract user in teaching activities [ ...…”

A systems‐centred approach to reducing medication error: Should pre‐hospital providers and emergency departments dose children by age during resuscitation?

“…These are predominantly person‐centred approaches, such as providing training, tools and feedback to individual health‐care providers and teams . An example of this approach was studied by Leach et al ., where ‘prescribing champions’ were given a number of workshops and ongoing weekly feedback using a ‘star chart game’ to try and reduce the high medication error rate in the paediatric intensive care unit and paediatric wards. This led to an initial improvement; however, this was not sustained .…”

“…An example of this approach was studied by Leach et al ., where ‘prescribing champions’ were given a number of workshops and ongoing weekly feedback using a ‘star chart game’ to try and reduce the high medication error rate in the paediatric intensive care unit and paediatric wards. This led to an initial improvement; however, this was not sustained . Other strategies include aids that provide pre‐calculated doses or algorithms that help with management; however, studies show that using the correct tool or remembering the right algorithm is another source of significant error .…”