Paediatric NIMC implementation and evaluation resources

The Paediatric National Inpatient Medication Chart

Implementation and evaluation resources

• Optimal implementation of the paediatric National Inpatient Medication Chart (NIMC) will involve use of multi-faceted strategies as part of a co-ordinated implementation program, suited to the needs of local settings.


• Appropriate education will form part of an effective implementation program. A range of educational resources is available to support education about safe prescribing and administration of medicines to paediatric patients and optimal use of the paediatric NIMC.


• Evaluation using clinically meaningful outcomes is strongly recommended. Selected indicators from the Quality Use of Medicines Indicators in Australian Hospitals (developed by the NSW Therapeutic Advisory Group and Clinical Excellence Commission) are well suited to this purpose. Children’s Hospitals Australasia Medication Safety Expert Reference Group recommends using the following indicators as a minimum set to form part of a more comprehensive evaluation of the paediatric NIMC nationally.





3.2 Percentage of patients whose known adverse drug reactions are documented on the current medication chart (PDF 64 KB)


3.3 Percentage of medications that include error-prone abbreviations (PDF 64 KB)


3.4 Percentage of paediatric medication orders that include correct dose per kg (or body surface area) and a safe total dose (PDF 64KB)


The whole indicator set is available at the NSW TAG Indicators for QUM in Australian Hospitals web page.

Ideally, evaluation of impact on clinically meaningful outcomes should include reliable measures of medication errors and harm events. However, nationally standardised tools are not yet available to measure these outcomes.

• Auditing appropriate use of the paediatric NIMC is also recommended at regular intervals to inform optimal implementation locally. A short audit tool (PDF 41 KB) and the standard audit tool (PDF 54 KB) are provided.


Meaningful national comparisons, both locally (across time) and nationally (at any point in time and longitudinally), will only be obtained by standardising audit parameter definitions and by standardising how and by whom data is collected.

It is strongly encouraged that, as a minimum, all facilities using the paediatric NIMC endeavour to achieve maximum adherence with the following core parameters.



• Accurate patient identification


• Accurate weight +/- height documentation


• Complete and accurate information about Adverse Drug Reactions (ADRs)


• Documentation of indication (regular and prn medicines)


• Correct dose (including documentation of the relevant mg/kg or mg/m2 basis for dose calculation and correct actual dose; as well as maximum daily dose for prn medicines being specified and correct)


• Use of approved abbreviations and avoidance of dangerous ones


• Scheduled medicines administration times correlating with frequency ordered by prescriber and actual administration times medicines given