Magister Pharmaceuticae - MPharm / The objectives of the present study were to describe the type and frequency of prescribing errors and error frequency, to determine the error frequency for different drug classes, to identify potential drug interactions and drug-disease interactions to point out off-label prescribing and to evaluate risk factors of prescribing errors. Methods: This prospective cross sectional study was conducted over a period of 6 months from July 2012 to December 2012 in 2 specialist wards and 2 general medical wards at Red Cross War Memorial Children’s Hospital in Cape Town in South Africa. Only prescriptions generated by doctors in the above mentioned wards were assessed. Convenience sampling was used to select 200 prescription charts for analysis. Information relating to prescribing error, potential drug interaction, potential drug-disease interactions, off-label prescribing and potential risk factors of prescribing error were entered into excel spreadsheet and analysed using STATA versions 11&12. The mass of the patients was converted into weight-for-age z-score (WAZ) using WHO 2006 child growth standards. Univariate analysis and multiple logistic regression were used to identify risk factors of prescribing errors. Results: Of the 200 children on whom prescribing information was analysed, 40 (20%) were severely underweight and a further 25(12.5%) were moderately underweight. A total of 1402 prescribing errors were documented in 1282 drug items prescribed, a rate of 1.09 errors per drug item prescribed. Incomplete prescription information was the most common type of prescribing error, present in 65.6% of all drug items prescribed. The error frequency was high for all drug classes ranging from 57.9% of all respiratory drug items prescribed to 86.4% of all gastro intestinal system drug items prescribed. The number of potential drug-drug interactions was low i.e. 20 potential pharmacodynamics and 49 potential pharmacokinetic drug interactions were identified. The number of potential drug-disease interactions was also low i.e. 39 or 0.03% per drug item prescribed. Furthermore 57 off-label prescribing incidences were recorded. Senior doctors posed a significant risk factor for prescribing errors, an OR 1.95, 95% CI 1.46 – 2.61. Conversely, prescriptions written up in the general wards compared to the specialty wards (an OR 0.65. 95% CI 0.47-0.90) and prescribing during weekends compared to weekdays (an OR 0.71, 95% CI 0.53-0.96) were associated with lower prescribing error risk. Conclusion: This study provided valuable information about prescribing practices in children at RCWMCH. There is a need to improve prescribers’ practice at RCWMCH considering the type of errors observed viz. missing information, use of wrong drug name, abbreviations, legibility concerns and lack of clarity of the prescriptions, among others. Based on this study results further intervention studies are recommended to investigate the level of medical student’s training w.r.t prescribing practice.

Inledning: Att vara på sjukhus med sitt akut sjuka barn är för många föräldrar en traumatisk upplevelse. Betydelsen av ett professionellt bemötande är av stor vikt för hur upplevelsen av vårdtiden blir. Syftet var att beskriva föräldrars upplevelser av vården när deras barn vårdades på en pediatrisk avdelning.Metod: För att besvara syftet och få en djupare förståelse för föräldrars upplevelse valdes en kvalitativ metod med semistrukturerade intervjuer. Totalt inkluderades åtta föräldrar i studien. Intervjuerna transkriberades och analyserades enligt tematisk analysmetod. Fynd: Analysen resulterade i tre teman: 1. Omvårdnadens olika uttryck: Genom att bli bemött med respekt och bli sedd som förälder upplevdes en trygghet i vården av barnet. 2: Föräldrars utsatthet: Att vara förälder till ett sjukt barn innebär en sårbarhet, och Sjukhusmiljö: Samtliga föräldrar uttryckte en tacksamhet över sjukvårdens olika resurser. Konklusion: Kompetent personal och ett gott bemötande är enligt föräldrar viktiga faktorer för att uppleva trygghet i vården. Det är av stor vikt att personal besitter god kompetens och vidareutbildas för att erhålla och bibehålla denna. En anpassning av sjukhusmiljö för barn och familjer, t.ex. i form av lekterapi, är av stor betydelse. / Introduction: To stay in the hospital with a critically ill child is for many parents a traumatic experience. The professionals´ approach has a great impact on how the actual treatment time is experienced. Purpose: The purpose was to describe parents' experience of care when their children were being cared for in a paediatric ward. Method: A qualitative approach with semi- structured interviews was chosen to answer the purpose, and get a deeper understanding of parents' experience. A total of eight parents were included in the study. The interviews were transcribed and analysed with thematic analysis. Findings: The analysis resulted in three themes: 1. Different expressions of nursing care: Parents wanted to be treated with respect, and be seen as a parent which in return made them feel confident in the care of the child. 2. Parental exposure: Being the parent of a sick child means vulnerability and 3 Hospital environment: All the parents in this study expressed a gratitude for the healthcare resources. Conclusion: Skilled personnel and a good attitude are key factors when experiencing confidence in health care. It is vital that staff possess good skills and further training to obtain and maintain this. It is also important with an adaptation of the hospital environment for children and families, such as in the form of play therapy.