Background Administration of oral formulations in children is challenging for paediatric nurses who face these matters in their daily practice. Available formulations are often not adapted for children younger than 6 years of age, leading to manipulation of formulation and off-license administration.
Purpose The purpose of this survey was to interview paediatric nurses on administration practices that would cause issues in children younger than 6 years old: extemporaneous capsules, marketed solid dosage forms (ie, capsules, tablets) and solution for injection via the oral route. We also enquired about information tools available to validate drug manipulations.
Material and methods A questionnaire was developed based on the most prescribed oral formulations in children younger than 6 over a 6 month period (September 2013 to February 2014), using data extracted from our hospital information system. It was distributed to nurses working within 6 paediatric units: endocrinology/general paediatrics, cardiology, nephrology/rheumatology, pulmonology, hepato-gastroenterology and neurology/epilepsy.
Results 59 nurses participated in the survey. They responded globally for extemporaneous capsules and solutions for injection; they answered case by case for a total of 273 marketed solid formulations. Using a numeric scale, they estimated 7.7 ± 1.7 years as the ideal age after which children properly swallow extemporaneous capsules, and 7.3 ± 1.8 years for marketed solid formulations. Moreover, 33% (19/57) and 43% (25/58) of nurses considered that prescribed treatments are not properly administered to a child younger than 6 years using extemporaneous capsules or solutions for injection; 37% (100/273) of prescribed marketed solid formulations would not be properly administered. Even in children able to swallow, 37% (21/57) of nurses systematically cut the tablets before administration in order to ease administration. Only 19% (11/58) of nurses declared disposing of an information tool to validate drug manipulations, with only one-third of them using it in their daily practice.
Conclusion This is the first survey that has reviewed administration issues for oral drug administration in children younger than 6 years of age. Adapting our questionnaire to each ward based on the most commonly administered oral drugs, we have provided precise information on the administration practices in paediatric hospital wards and issues faced by paediatric nurses.
References and/or Acknowledgements French Medicine Agency (ANSM) funding; EREMI team.
No conflict of interest.
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