The safety of computerised prescribing in hospitals

Baysari, Melissa T.; Raban, Magdalena Z.

doi:10.18773/austprescr.2019.037

Cited by 18 publications

(14 citation statements)

References 23 publications

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“…Davies et al [ 23 ] found that health care staff’s perception of safety culture deteriorated after electronic prescribing was introduced. Despite this, CPOE remains a key part medication error prevention [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system

2020

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Background Computerised Physician Order Entry (CPOE) is considered to enhance the safety of prescribing. However, it can have unintended consequences and new forms of prescribing error have been reported. Objective The aim of this study was to explore the causes and contributing factors associated with prescribing errors reported by multidisciplinary prescribers working within a CPOE system. Main Outcome Measure Multidisciplinary prescribers experience of prescribing errors in an CPOE system. Method This qualitative study was conducted in a hospital with a well-established CPOE system. Semi-structured qualitative interviews were conducted with prescribers from the professions of pharmacy, nursing, and medicine. Interviews analysed using a mixed inductive and deductive approach to develop a framework for the causes of error. Results Twenty-three prescribers were interviewed. Six main themes influencing prescribing were found: the system, the prescriber, the patient, the team, the task of prescribing and the work environment. Prominent issues related to CPOE included, incorrect drug name picking, default auto-population of dosages, alert fatigue and remote prescribing. These interacted within a complex prescribing environment. No substantial differences in the experience of CPOE were found between the professions. Conclusion Medical and non-medical prescribers have similar experiences of prescribing errors when using CPOE, aligned with existing published literature about medical prescribing. Causes of electronic prescribing errors are multifactorial in nature and prescribers describe how factors interact to create the conditions errors. While interventions should focus on direct CPOE issues, such as training and design, socio-technical, and environmental aspects of practice remain important.

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Section: Introductionmentioning

confidence: 99%

A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system

2020

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“…Electronic prescribing strategies reduce medication errors and adverse drug reactions. 11 There is growing evidence that 12,13 All sites included in this study were paper-based medication prescribing and we are unable to comment if the use of an EMR would impact results. There is a gap in the literature to support collaborative pharmacist prescribing on admission and discharge internationally.…”

Section: Discussionmentioning

confidence: 93%

“…Electronic prescribing strategies reduce medication errors and adverse drug reactions 11 . There is growing evidence that electronic systems can introduce new types of errors with a study from the United States identifying 22 types of errors facilitated by an EMR 12,13 . All sites included in this study were paper‐based medication prescribing and we are unable to comment if the use of an EMR would impact results.…”

Section: Discussionmentioning

confidence: 96%

Partnered pharmacist medication charting (PPMC) in regional and rural general medical patients

Tong

Hua

Edwards

et al. 2022

Australian J Rural Health

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Objective: Errors in hospital medication charts are commonly encountered and have been associated with morbidity and mortality. This study evaluates the impact of the Partnered Pharmacist Medication Charting (PPMC) model on medication errors in general medical patients admitted to rural and regional hospitals.Design/Method: A prospective cohort study, comparing before and after the introduction of PPMC was conducted in 13 rural and regional health services. This included a 1-month pre-intervention phase and 3-month intervention phase. In the intervention phase, PPMC was implemented as a new model of care in general medical units.

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“…Secondly, due to the setting of the current prescription assessment, errors such as wrong drugs because of 'reada-likes' are less likely to be made. 33 Thirdly, analysing the results of assessments is a great way to scrutinize a curriculum; it gives new insights on how to optimize the education given. This way of assessing a curriculum is applicable and recommendable for all faculties.…”

Section: Discussionmentioning

confidence: 99%

How would final‐year medical students perform if their skill‐based prescription assessment was real life?

Kalfsvel

Hoek

Bethlehem

et al. 2022

Brit J Clinical Pharma

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Aims Prescribing errors occur frequently, especially among junior doctors. Our aim was to investigate prescribing errors made by final‐year medical students. Information on these errors can help to improve education on and assessment of clinical pharmacotherapy (CPT). Methods This was a retrospective cohort study amongst final‐year medical students at Erasmus Medical Centre, The Netherlands. Errors made in the final prescribing assessment were analysed. Errors were categorized by type, possible consequence and possibility of reaching the patient in real life. Results A total of 381 students wrote 1502 analysable prescriptions. Forty per cent of these contained at least one error, and 54% of errors were of the inadequate information type. The rating of prescriptions for children was lower than for other question categories (P = <.001). Fifty per cent of errors were classified as “would have reached the patient but would not have had the potential to cause harm”. In total, 253 (29%) errors would not have been intercepted by an electronic prescribing system or a pharmacist. Ten (4%) of these would probably have caused harm in the patient. Conclusions There is a high rate of errors in prescriptions written by final‐year medical students. Most errors were of the inadequate information type, indicating that students had difficulties determining the content and amount of information needed to make treatment successful. Prescriptions for children contained most errors. Curricula could be improved by offering more case‐based CPT education, focusing on the practical issues of prescribing, especially for paediatric cases, and offering more practice time for prescribing during clerkships.

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The safety of computerised prescribing in hospitals

Cited by 18 publications

References 23 publications

A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system

A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system

Partnered pharmacist medication charting (PPMC) in regional and rural general medical patients

How would final‐year medical students perform if their skill‐based prescription assessment was real life?

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