62. CAN I TRUST YOU? DO PEDIATRIC RESIDENTS WRITE SAFE PRESCRIPTIONS?

Abstract

Purpose The 2014 Core Entrustable Professional Activities (EPAs) for Entering Residency state that residents should be entrusted to write prescriptions and medication orders in all settings at the start of their residency training without direct supervision. This pilot aimed to determine if Pediatric residents of all levels at The University of Toledo College of Medicine and Life Sciences (UTCOMLS) were writing safe electronic prescriptions in continuity clinic. Based on Kolb s Experiential Learning Theory, residents’ skills should improve with increased prescription writing over time. Methods The first ten electronic prescriptions written by each resident during continuity clinic starting in July 2017 were retrospectively reviewed (n=270). PGY level and the method of Sig entry (decision support vs free text) were recorded. Prescription components (dose, route, frequency, etc) were recorded as either correct or incorrect. Percent incorrect for each item was used to determine common errors, and Pearson chi-square analysis was used to determine statistical significance between percent incorrect versus PGY level as well as method of Sig entry. Results Common errors found on prescriptions included PRN not tied to a reason (57% of 77 scripts) and incorrect duration of treatment (26% of 73 scripts). For weight-based medications, neither a weight-based dosing standard nor the patient s weight was noted on the prescription 98% of the time. There was no statistical significance in errors made by PGY level. There were significant differences in errors made based on the method of Sig entry. A route was noted less often if the Sig was written with free text (p Conclusion Pediatric resident prescriptions contained several errors. Upper level residents made just as many and the same type of errors as junior residents. This suggests experiential learning does not help improve prescription writing skills, and residents would benefit from education on safe prescribing guidelines and regular feedback throughout their training.