4CPS-220 Prescribing errors in parenteral nutritional support for adolescent paediatric patient

<h3>Background and Importance</h3> Adolescents represent one of the paediatric populations at highest risk for medication errors (ME) due to individualised dose calculations based on weight, a parameter with high variability in this paediatric age. Pharmacist intervention may be essential to reduce ME in parenteral nutrition (PN), especially in weights greater than 40 kg as indicated in the literature, to make sure that the maximum recommended dose is not exceeded. <h3>Aim and Objectives</h3> To analyse pharmaceutical interventions that were accepted by the prescribing physician to adjust adolescent PN related to ME due to macro/micronutrient doses above the maximum recommended, and to compare interventions between patients weighing &gt;40 kg and patients weighing &lt;40 kg. <h3>Material and Methods</h3> Observational, descriptive, and retrospective study carried out on adolescents (13–17 years) who received PN in a tertiary hospital paediatric unit between January 2022 and May 2024. Variables were collected from medical records: age, gender, weight, number of PN, type of intervention and macro/micronutrients adjusted. Interventions to adjust osmolarity or stability of the lipid emulsion were excluded. The reference guidelines for pharmacist interventions were the 2018 ESPGHAN/ESPEN/ESPR guidelines on paediatric parenteral nutrition and the 2009 SEFH standardisation of specialised nutritional support. A descriptive analysis of qualitative variables was performed, expressed as numbers and percentages (%). Quantitative variables were expressed as mean ± standard deviation (SD). <h3>Results</h3> A total of 39 adolescent patients were included, 20 (53%) were male, mean age 14.4 (1.3) years, with 717 PN validated by a hospital pharmacist. Patients ≤ 40 kg: 8; mean weight 27,8 (7,8) kg; number of PN: 109. Pharmaceutical interventions: 7, none due to higher doses. Patients &gt; 40 kg: 31; mean weight 55,9 (13,2) kg; number of PN: 608. Pharmaceutical interventions: 67, corrections due to high weight: 20 (30%) in 15 (48%) patients. Most adjusted micronutrients: magnesium and calcium (n=13), and phosphorus (n=7). Most adjusted macronutrient: glucose (n=19). <h3>Conclusion and Relevance</h3> This study suggests that in nutritional therapy, patients weighing over 40 kg are more likely to experience dosing errors in both micronutrients and macronutrients. This underscores the critical importance of hospital pharmacists’ involvement and integration within the nutrition management team to ensure the accuracy and safety of nutritional preparations, particularly for adolescent patients who require specialised considerations. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest