The Commission held a seminar to assist public and private hospitals safely implement paediatric versions of the NIMC.
- Paediatric National Inpatient Medication Chart Report 2009 (PDF 170KB)
- Implementing the paediatric NIMC within a general hospital (PDF 108kb)
- Implementing the Paediatric NIMC at Royal Children’s Hospital Melbourne: Sharing the lessons (PDF 88kb)
- Sydney Children’s Hospital: Experience and national resources for implementation (PDF 755kb)
- National evaluation of the paediatric NIMC (PDF 2.4mb)
- Medication safety strategies for children (PDF 1mb)
- Responding to safety alerts in the paediatric environment (PDF 755kb)
- Using Medication Safety Self Assessment and Indicators for Quality Use of Medicines in paediatric settings (PDF 824kb)
Implementation and evaluation resources
Optimal implementation of the paediatric 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’s 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)
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
Prepared by Madlen Gazarian, Linda Graudins, Sonya Stacey and Joanna Holt, on behalf of Children’s Hospitals Australasia, Medication Safety Expert Reference Group, June 2008
To improve the safety and quality of medicines use nationally, Australian Health Ministers required all public hospitals in Australia to use a common medication chart. The National Inpatient Medication Chart (NIMC) was developed by a multi-disciplinary national working party.
Similarly, a nationally agreed paediatric version has been developed, sharing many features with the original NIMC, but incorporating additional features important for safely using medicines in the paediatric population. Short stay (5 days) and long stay (21 days) versions are available.
Below are a range of education resources for safe prescribing in hospitalised paediatric patients and which will support implementation of the paediatric NIMC. These resources have been developed by multi-disciplinary teams of clinicians (see acknowledgments below) and are designed for use by doctors, nurses and pharmacists.
All facilities caring for paediatric inpatients are invited to use these resources to support the optimal use of the paediatric NIMC for improving paediatric medication safety. We request that you:
- Acknowledge the source;
- Adapt the content to your facility, as some material is specific to Sydney Children’s Hospital and may need modification for other settings;
- Evaluate outcomes (see recommended indicators above)
Paediatric educational resources
- Paediatric NIMC fact sheet (PDF 85 KB)
- Paediatric NIMC PowerPoint presentation (PDF 2400 KB)
- Paediatric NIMC PowerPoint presentation with speakers notes (PDF 2325 KB)
- Sydney Children’s Hospital safe prescribing guidelines (PDF 48 KB)
- Sydney Children’s Hospital allergy and adverse drug reaction definitions (PDF 52 KB)
- Recording and reporting adverse drug reactions: MEDIscene Feb 2005 (PDF 96 KB)
Frequently asked questions
Links to general resources
Let us know whether you found the material useful (and why). Suggestions for improvements are very welcome. Please send your feedback to email@example.com.
This educational package was developed by Dr Madlen Gazarian (Paediatric Clinical Pharmacologist and Head) and Ms Linda Graudins (QUM and Medication Safety Pharmacist), both of the Paediatric Therapeutics Program, University of NSW & Sydney Children’s Hospital, Randwick.
The paediatric resources are based on material originally developed as part of a medication safety improvement program at Sydney Children’s Hospital, with input from the Medication Safety Improvement Project Team and the Adverse Drug Reactions Working Party. Material from NIMC educational resources available through various state and national bodies (see Links to General Resources) have been incorporated, including material developed by the Pharmacy Department, Children, Youth and Women’s Health Service, Adelaide (Lauren Cortis), whose input is gratefully acknowledged. Multi-disciplinary input from clinicians (including nurse educators, senior pharmacists and Chief Resident Medical Officer) at Sydney Children’s Hospital informed the development of the final package.
This package has been reviewed and approved by members of Children’s Hospitals Australasia’s Medication Safety Expert Reference Group to support the optimal use of the paediatric NIMC and to improve paediatric medication safety. Their contribution is gratefully acknowledged. June 2008.