Policy statement​

• Sites should define age range for pediatric population

• Weight should be recorded at every ED encounter

• Ensure that either an actual weight (i.e., gurney weight) or weight based on patient length (i.e., using the length-based tape) is used for all resuscitations

• Frequency that ED pharmacists attend a pediatric resuscitation and assist with medication administration

​

Infrastructure changes

• Utilize a scale that only weighs pediatric patients in kilograms or can be locked in kilograms

• Utilize gurney weights on all patients for whom staff are unable to get a scale weight

• Utilize a length-based tape and ensure that it is available

• Utilize a single formulation for each medication

​

Electronic medical record (EMR) optimization

• EMR alerts care team when weight is not recorded in correct unit

• EMR alerts care team that weight does not coincide with patient’s height and age

• For resuscitation, weight is a required entry in the patient’s medical record

• Consider using standard weight nomograms (e.g., World Health Organization)

• EMR automatically calculates medication dosing based on weight recorded in kilograms in medical record

​

Education

• Integrate ED pharmacists into the healthcare team

• Develop training/educational content for care team

  • Learning objectives should include: proper use of length-based tape, necessity of weight measurement required in cases of resuscitation, safety issues (e.g., number of reported medication errors), methods of measuring weight, nomograms, family engagement, your site’s policy; PRQC change strategies)

  • Identify training modality (e.g., online, in-person, staff-meetings, peer to peer, EMR alerts)

• Identify strategies to increase families’ engagement

• Weight should not be estimated but measured

 

Knowledge reinforcement for care team

• Posters in triage and clinical care areas

• Direct feedback to care team following chart audits

• Develop script for use by triage nurse

​

Patient & Family Engagement

• Offer families a preprinted chart with their child’s measured weight in kilograms and corresponding pounds. Template here.

• Disseminate weight infographic/conversion chart to empower caregiver engagement. Template here. 

​

Prescribing Patterns (deep dive for outcome measure)

• Manually track the number of incidences when an incorrect dose of a medication was ordered for a patient based on their weight

• Track high risk conditions with common errors in prescribing and administration medication administration (deep dive for outcome measure)

• Integrate a tool that nurses can reference to ensure that medication dosing is appropriate (use standard nomograms as reference)

• Integrate a nurse-to-nurse cross-check to ensure that medication dosing is appropriate. If site has bandwidth to accommodate this effort, consider cross-check for high-risk patients/medications or cross-checks during off-peak hours in the ED.

• Work with pharmacy team to develop notification system in the event that a prescribed medication does not coincide with standard practice

​

​

Additional content

• Collated content and resources

EIIC PRQC Weight in Kg Intervention Bundle (2016)

EIIC PRQC Weight in Kg Intervention Bundle (2023, in process)

​​

• Infographic

​            Weight in kg only infographic​

​

• Videos 

https://vimeo.com/827397878 

https://vimeo.com/831634589 

 

• Publications, Position Statements

ENA Position Statement

NAEMSP Position Statement

NEMSQA Pediatrics-03b Measure Package

​

​

​