Implementation Of Electronic Prescribing Research Articles

Republished error management: Paediatric dosing errors before and after electronic prescribing

ObjectiveTo compare the incidence and severity rating of dose prescribing errors before and after the implementation of a commercially available electronic prescribing system at a tertiary care children's hospital.MethodsDose errors...

A clinical information system reduces medication errors in paediatric intensive care

To determine the effect of electronic prescribing (EP) with a clinical information system (Intellivue Clinical Information Portfolio, Philips, UK) on prescribing errors and omitted doses in a paediatric intensive care unit (PICU). Prospective audit of prescribing errors and omitted doses for 96 h periods in three epochs: (1) before implementation of EP, (2) 1 week and (3) 6 months later. There was a non-significant reduction in prescribing errors: 8.8% (95% CI 4.4-13.2) pre-implementation of EP versus 8.1% (4.4-11.8) 1 week after implementation and 4.6% (2.0-7.2) 6 months later. The prevalence of omitted doses decreased significantly 6 months following implementation, changing from 8.1% (5.8-10.4) pre-implementation to 10.6% (6.5-14.7) 1 week after implementation and 1.4% (CI 0-2.8%) 6 months after implementation (P < 0.05). EP within a clinical information system increases medication safety in a PICU.

Paediatric dosing errors before and after electronic prescribing

ObjectiveTo compare the incidence and severity rating of dose prescribing errors before and after the implementation of a commercially available electronic prescribing system at a tertiary care children's hospital.MethodsDose errors...

Drug errors before and after implementation of electronic prescribing on paediatric intensive care unit: Abstract G80 Table 1

Aims To identify the number and type of prescribing errors and dose omissions before and after implementation of electronic prescribing on Carevue (Phillips, UK), an ICU clinical information system, installed in our paediatric intensive care unit (PICU) in February 2009. Methods Prospective audit of prescribing errors and missed doses for 96-h periods in three epochs—before implementation of Carevue (Epoch 1), one week after implementation of Carevue (Epoch 2) and 6 months after implementation of Carevue (Epoch 3). Prescribing errors were further classified as incomplete prescription, insufficient information, illegible prescription, prescribing error and other. The χ 2 was used to compare proportions. Results Electronic prescribing on Carevue was associated with a significantly lower incidence of missed doses, likely due to electronic worklists and alerts for nursing staff. There was also a tendency towards a lower incidence of prescribing error, likely due to predefined standard orders for drugs and infusions commonly used on the PICU (figure 1). Incomplete prescription, insufficient information and illegible prescriptions as causes of prescribing error were not seen following implementation of Carevue. Conclusions A clinical information system can significantly reduce the incidence of drug errors in PICU.

Extent of Electronic Prescribing Implementation as Perceived by MCO Pharmacy Managers

(82%) had discussed implementing electronic prescribing, 11 (25%) had developed a plan, but only seven (16%) had actually implemented electronic prescribing. This distribution was observed regardless of MCO type or membership size or membership type. Provider resistance appeared to be rated as the highest barrier by those who considered implementation of electronic prescribing not feasible. In contrast, responders who had the opportunity to implement electronic prescribing appeared to rate the investment requirement as the highest barrier. CONCLUSIONS: The extent of electronic prescribing implementation by MCOs might be minimal. Barriers to implementation may appear overwhelming at the early stages of discussion, but may change as the implementation process progresses.