P2.E089: Enhancing Medication Safety in Pediatric Acute Care Through Improved Weight Estimation and Patient-Specific Dosing

Background: Medication errors are prevalent in pediatric acute care, affecting one in four children. High-stress environments, reliance on weight-based medication dosing, and error-prone preparation of intravenous medications contribute to the high rate of medication errors in pediatrics. Existing solutions often lack either pediatric-specific adaptations or integration with hospital medication formularies, hindering their effectiveness in mitigating medication errors. To address this critical gap in care, a novel comprehensive system was developed, featuring two key components: (i) a Smart Weight Band, which provides an accurate body weight for the patient from arm-based measurements and (ii) a medication dosing software designed for pediatric acute care.

Methods: Two clinical studies were conducted at tertiary care pediatric teaching hospital. A usability study assessed the pediatric medication dosage software's usability, safety features, and ease of use through semi-structured interviews with pediatric hospital pharmacists and pediatric emergency medicine physicians and nurses. Qualitative data was analyzed using thematic analysis to identify key themes. This was followed by a clinical validation study (REB #: 2023-8628) that compared the accuracy of the Smart Weight Band against clinical standard, the Broselow Tape, in estimating weight in pediatric participants (aged 2 months to 17 year). Research assistants measured participants’ weight using both methods, and the predictive performance was assessed by calculating the percentage of weight estimates falling within 10 and 20% of the participant’s actual weight from a standard hospital scale.

Results: Feedback from the healthcare professionals (N=40) during the usability study highlighted positive aspects of the medication dosing software which included its intuitive interface for dose calculation and medication preparation, improved workflow efficiency, and functionalities to ensure Y-site compatibility. Results from the clinical validation study demonstrated the Smart Weight Band (N=67) had superior accuracy compared to the Broselow Tape. The Smart Weight Band was within 10% of the participant’s weight, in 74.6% of cases compared to the Broselow Tape (N=41) which was within 10% of the participant’s weight in 56.1% of cases. Further analysis by age group revealed the Smart Weight Band’s accuracy across all age groups as weight estimates were within 20% of the actual weight in 93.5% of 2 months to 4 year olds, 85.7% of 5 to 7 year olds, and 100% of 8 to 17 years, respectively.

Conclusion: Medication errors that occur in pediatrics can have a ten-fold effect and can have serious consequences to the patient due to weight-based dosing. This integrated system offers a novel approach to enhance medication safety and accuracy in pediatric acute care. Further clinical studies will be crucial to evaluate the system’s broader impact on the reduction of medication errors within pediatric healthcare settings.