Safe prescribing, administration and monitoring — branching viva

Opening (candidate)

I would treat this as two linked problems: a supratherapeutic gentamicin level that needs immediate action, and a system question about how we prevent high-alert-medicine errors. For the level, I would stop or extend the gentamicin, assess renal function and the child for toxicity, and review the prescribing and monitoring chain. For prevention, I would describe the layered system — decision-supported prescribing, unit-based pharmacists, standard concentrations, independent checks, reconciliation, and monitoring with level-to-action protocols. [9] [6]