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Medication errors with electronic prescribing (eP): Two views of the same picture.

Savage, I; Cornford, T; Klecun, E; Barber, N; Clifford, S; Franklin, BD; (2010) Medication errors with electronic prescribing (eP): Two views of the same picture. BMC Health Serv Res , 10 , Article 135. 10.1186/1472-6963-10-135. Green open access

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Abstract

Background Quantitative prospective methods are widely used to evaluate the impact of new technologies such as electronic prescribing (eP) on medication errors. However, they are labour-intensive and it is not always feasible to obtain pre-intervention data. Our objective was to compare the eP medication error picture obtained with retrospective quantitative and qualitative methods. Methods The study was carried out at one English district general hospital approximately two years after implementation of an integrated electronic prescribing, administration and records system. Quantitative: A structured retrospective analysis was carried out of clinical records and medication orders for 75 randomly selected patients admitted to three wards (medicine, surgery and paediatrics) six months after eP implementation. Qualitative: Eight doctors, 6 nurses, 8 pharmacy staff and 4 other staff at senior, middle and junior grades, and 19 adult patients on acute surgical and medical wards were interviewed. Staff interviews explored experiences of developing and working with the system; patient interviews focused on experiences of medicine prescribing and administration on the ward. Interview transcripts were searched systematically for accounts of medication incidents. A classification scheme was developed and applied to the errors identified in the records review. Results The two approaches produced similar pictures of the drug use process. Interviews identified types of error identified in the retrospective notes review plus two eP-specific errors which were not detected by record review. Interview data took less time to collect than record review, and provided rich data on the prescribing process, and reasons for delays or non-administration of medicines, including "once only" orders and "as required" medicines. Conclusions The qualitative approach provided more understanding of processes, and some insights into why medication errors can happen. The method is cost-effective and could be used to supplement information from anonymous error reporting schemes.

Type: Article
Title: Medication errors with electronic prescribing (eP): Two views of the same picture.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/1472-6963-10-135
Publisher version: http://www.biomedcentral.com/1472-6963/10/135
Language: English
Additional information: PMCID: PMC2890639 © 2010 Savage et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Adult, Electronic Prescribing, England, Evaluation Studies as Topic, Female, Hospital Units, Hospitals, District, Humans, Interviews as Topic, Male, Medical Staff, Hospital, Medication Errors, Organizational Policy, Pediatrics, Pharmaceutical Preparations, Qualitative Research, Retrospective Studies, Surgery Department, Hospital
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/1351553
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