Safe prescribing, administration and monitoring

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Target exams

Red flags

• Writing a weight-based dose without an independent second check, or after estimating the weight instead of weighing the child
• A ten-fold dosing error from a misplaced decimal point, a trailing zero, or a misread unit
• Giving a high-alert medicine (insulin, opioid, concentrated electrolyte, anticoagulant, chemotherapy) without an independent double-check
• Missing a supratherapeutic or subtherapeutic level because a gentamicin, vancomycin or phenytoin level was not taken or not acted on
• Reconciling medicines poorly at admission, transfer or discharge so a medicine is doubled, stopped or omitted
• Using an abbreviation, a look-alike name, or a non-standard concentration on a free-text prescription

Life stages

Care settings

Clinical exam formats

Board mappings

• General and Community Paediatrics — safe prescribing and medication safety
• Quality and safety — preventing medication errors
• Patient safety and quality improvement — medication safety systems
• Scholarly activity — audit of medication errors and therapeutic monitoring
• Safe prescribing, the rights of medication administration, and dose calculation
• Therapeutic drug monitoring interpretation (gentamicin, vancomycin, phenytoin)
• Long and short case discussion of a medication error or a high-alert medicine
• Structured discussion of medication reconciliation at transitions of care
• Patient safety and quality improvement: safe prescribing and medicines management
• Safeguarding themes — recognising harm from medication errors
• Foundation of Practice (FOP) — pharmacology and safe prescribing
• Applied Knowledge in Practice (AKP) — medication safety and monitoring
• History taking and management — safe prescribing and counselling
• Communication scenarios — explaining a medication error to a family
• General Pediatrics Content Outline — patient safety, medication management and pharmacology
• Systems-based practice — error prevention and therapeutic drug monitoring
• Systems-Based Practice: medication safety systems and reporting
• Practice-Based Learning and Improvement: auditing prescribing errors
• Patient Safety — high-alert medications and dose checking
• Patient Safety and Quality Improvement — safe medication use
• Medical Expert — pharmacology and therapeutic drug monitoring
• Collaborator — working with pharmacy and nursing on medicines safety