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Neonatal vancomycin prescription chart

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Context

Prior to the development of this prescription chart we had multiple drug errors relating to prescribed dose miscalculations, schedule and drug monitoring requirements, in neonatal unit at Leeds' Children's Hospital. The system we had used previously was an IT based one which was unfortunately not fit for purpose due to system failures as well as the ability to override certain parameters, leading to further errors. The system also required passwords (that were never issued to locums or non-regular staff, caused lots of problems) and that was quite restricting with regards to dosing and timings of prescriptions that could be issued.

Aims

To provide a safe and effective tool for the prescribing and administration record of vancomycin in neonates. For this tool to be readily available and provide a reference for dosing and monitoring requirements. To reduce prescribing errors associated with the prescribing of vancomycin and prevent harm.

Description

A purpose designed prescription chart with prescribing guidance and clear information of monitoring of pharmacokinetics and dose adjustments.

Implementation

This prescription chart has been successfully implemented on the neonatal unit at Leeds Children's Hospital and is available for use in areas that may receive neonates as inpatients. It has prevented access errors (IT based system previously used) and has successfully provided the team with guidance in situations requiring dose adjustments.

Suggestions for further implementation

As this tool has been specifically designed for the prescribing, administering and monitoring of vancomycin prescriptions it is not recommended that it is used for other purposes. Certain aspects, such as design and layout, may be possible to use and adapt.

Challenges and learning

This tool has been particularly successful and was a welcomed change to the previous system that we had in place. The support of the medical team and the nursing team were highly instrumental in ensuring that this new prescribing tool was implemented promptly and effectively.

Quality assurance/MHRA registration

This prescription chart has been approved locally by the Leeds Teaching Hospitals NHS Trust prescription stationery group.