Accurate Dosing Weight: When the 10% Really Matters.

UNITED States; NEW South Wales

Introduction: Children are at increased risk of medication-associated adverse events, often due to weight-based dosing errors. We aimed to reduce the proportion of medications that were administered where the dosing weight was = 10% different from the recorded weight. Methods: We adopted in-situ usability testing to iteratively improve design of clinical decision support that would enable accurate dosing weight documentation by prompting clinicians to update weight if recorded weight was > 10% different and it had been at least 7 days since the last dosing weight update. Results: The proportion of medication administrations with difference >10% between their recorded weight and dosing weight decreased from 13.1% (56,256/429,006) in the baseline period to 9.5% (35,560 / 372,443) in the intervention period (P < 0.001). Discussion and Conclusion: User-centered design of an interruptive alert improved the accuracy of dosing weights during medication administrations without substantial alert burden. In-situ usability testing is an effective approach to rapidly obtain feedback from frontline users and iterate on the design to effect desired behavior changes. [ABSTRACT FROM AUTHOR]

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