Leveraging the EHR to Promote Pharmacy Adoption of Dosing Best Practices and Reduce Parent Errors in Administering Pediatric Liquid Medications: A Health Literacy-Informed Approach
Brief description of study
This is a pre-/post-implementation study that will be performed with English- and Spanish-speaking parents of children prescribed oral liquid medications (dose 10mL or less) in the pediatric emergency room, outpatient general pediatric clinic, and pediatric subspecialty clinics of 2 New York city hospital systems (NYU Langone Health – Brooklyn and NYC Health+Hospitals - Bellevue Hospital). A total of 500 subjects will be recruited across the 2 hospital systems, 250 pre-implementation and 250 post-implementation. Our intervention is an EHR-based intervention that leverages electronic prescriptions (e-Rx’s) to support optimal pharmacy dispensing practices (maintenance of dosing instructions in mL-only on prescription bottle labels and provision of optimal dosing tools) and reduce parent dosing errors. This intervention will be built directly into the Epic electronic health record (EHR). Prior to implementation, e-Rx’s will be generated by the EHR in the usual fashion; after implementation, e-Rx’s will be generated by the EHR with instructions to the dispensing pharmacy to: 1) keep the dosing instructions in mL-only, and 2) dispense a specific dosing tool based on the amount prescribed. Additionally, we will conduct post-trial investigations assessing pharmacy staff perceptions of the intervention. Interviews with a convenience sample of pharmacy staff (n=30) will be performed for feedback on e-Rx requests, including assessment of acceptability and barriers to following recommended guidance.
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