Paediatric Prescribing Tool

Introduction

The Paediatric Prescribing Tool (PPT) has been developed as a rapid response to recent critical incidents of gross prescribing errors affecting children. A small working party of members of Royal College of Paediatrics and Child Health (RCPCH) and Neonatal and Paediatric Pharmacists Group (NPPG) created the tool based on best practice and other similar tools in current use.

PPT was pilot tested by approximately 40 prescribers of different grades in five Trusts. In the medium term an education package and more sophisticated tool are in development. This tool is part of a portfolio of prescribing resources available or in development at RCPCH. 

Since Clinical Governance responsibility for safe prescribing rests with each Trust,
the College recommends that local guidelines are established to determine the capacity of each individual to prescribe safely based on the outcomes from the prescribing assessment.

Teaching Presentation

The presentation below has been designed to allow you to introduce safe prescribing procedure to your trainees.  A commentary explaining each slide is given in the note field on each slide. You can full customise the slides to include your own trust name and details.

Paediatric Prescribing Tool

 

(Please note that this presentation was kindly put together by the London Deanery and they are happy for others to use and amend it, however please do acknowledge the London Deanery as the original source of this work)

Purpose

PPT is intended to alert supervising consultants that one of their staff needs extra support for paediatric prescribing. The charts should be marked locally and the results fed back to the doctors taking the test. A suggested assessment scheme is attached highlighting entries that the RCPCH/NPPG group feel are “Essential” and those that are “Desirable”. Pilot testing indicated a wide variety of responses suggesting that whilst some entries are absolutely mandatory, others can be viewed more flexibly.

Methods

Pilots suggest it takes 20 minutes to complete, and 5-10 minutes to mark. The prescriptions should be made on a local Trust drug chart (as these vary between different hospitals).

It is envisaged that a judgment could be made for three possible outcomes:

  1. Unrestricted prescribing rights
  2. Prescribing under close supervision
  3. Restricted prescribing pending further assessment

It is anticipated that only a few will perform so poorly on the scenarios that they need remediable support. However, feedback data will inform future scenario and assessment schemes.

Many Trusts provide a short induction on safe prescribing (including topics such as specific issues for paediatric prescribing, including calculation of drug doses, analgesic doses, IV fluid prescriptions and pitfalls in prescribing antibiotics). If this is not available, as a minimum, we suggest the prescriber is provided with the “Top tips” before the test. 

Feedback

We would greatly appreciate feedback on what you think of the presentation and/or the prescribing assessment tool. Please email the Education & Traing Support Team with any comments you have.

Paediatric Prescribing Toolkit

Paediatric Prescribing Tool: Top Tips

Paediatric Prescribing Tool: Scenarios

Paediatric Presecribing Tool: Assessor's Sheet