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Eur J Hosp Pharm 20:A18 doi:10.1136/ejhpharm-2013-000276.049
  • General and risk management, patient safety

GRP-049 Design and Development of a Prescription Module of Enteral Diets For a Neonatal Unit

  1. MD Rivas Santayana
  1. Hospital Universitario Marqués de Valdecilla, Pharmacy, Santander, Spain

Abstract

Background A safety problem occurred in requesting enteral diets (EDs) in the neonatal unit. So we decided to develop a special prescription module for requesting EDs.

Purpose To describe the design and development of a prescription and request module for EDs in a neonatal unit.

Materials and Methods The first step was to assemble all the EDs, such as milks, supplements or fortifiers and described the composition of these products, indicating total kilocalories, macronutrients (grammes of protein, lipids and carbohydrates), micronutrients (mg and mEq of Na, K, Cl, Ca and Mg, mg and mMol of P, mg of elemental iron, IU of vitamin D3) and osmolarity (mOsm/L).

Many of these data weren’t in the product’s package leaflet, so it was necessary to contact the manufacturer to request this information.

We decided to include the name of the diet, frequency, administration route and type and unit of administration in the ED prescription module.

Results The neonatal computer physician order entry (CPOE) now has another option, the ED module. The prescriptions also include the weight of the patient. When the physicians select ED, they can view the qualitative and quantitative composition of the formula. The prescription module calculates macronutrients provided for that prescription (g/kg/day), micronutrients (mg/kg/day, mEq/kg/day or mMol/kg/day), total kilocalories (kcal/kg/day) and osmolarity (mOsm/L).

The prescribed diet is checked against nutritional requirements obtained from the European Society of Paediatric Gastroenterology and Nutrition guidelines.

Finally, the software can generate the request for the diets without the necessity of handwritten requests.

Conclusions ED can cause medication errors, such as transcription problems, excessive or miscalculated macro and micronutrients or errors in route of administration. These errors may have clinical impact on children and can be more serious in preterm infants. The ED prescription module is an excellent tool to prevent errors and facilitate the nutritional calculations.

No conflict of interest.

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