The impact of an integrated electronic medication prescribing and dispensing system on prescribing and dispensing errors: a before and after study. (30th March 2017)

• Record Type: Journal Article
• Authors: Hodgkinson, Marisa R.; Larmour, Ian; Lin, Susan; Stormont, Adam J.; Paul, Eldho
• Is Part Of: Journal of pharmacy practice and research. Volume 47:Number 2(2017)
• Page Start: 110
• Page End: 120
• Publication Date: 2017-03-30
• Subjects: electronic prescribing -- dispensing -- prescribing errors -- drug safety -- E‐health; Hospital pharmacies -- Australia -- Periodicals; Pharmacy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1002/jppr.1243
• Languages: English
• ISSNs: 1445-937X

Abstract

Abstract: Background: Medication errors are a significant problem in Australian hospitals. This is the first study of the impact of an integrated electronic medication prescribing (e‐prescribing) and dispensing system on medication errors. Aim: To evaluate the impact of an integrated e‐prescribing and dispensing system implemented in outpatient clinics and the emergency department on prescribing and dispensing errors. Method: Prescribing and dispensing errors were identified over 2 weeks before and after implementation of the integrated system. Errors were identified through original prescription, e‐prescribing and dispensing systems review. Error rates, types, severity and patient waiting times for prescription dispensing were compared. Results: The study included 379 patients prescribed 654 medicines in the before group and 375 patients prescribed 635 medicines in the after group. Prescribing and dispensing error rates per patient were reduced by 93% (from 2.98 to 0.2; p < 0.0001) and 98% (from 1.27 to 0.03; p < 0.0001), respectively. The proportions of patients with at least one procedural or clinical prescribing error showed significant reductions of 81% (95% CI 77–85%) and 3.4% (95% CI 0.1–6.7%). The proportions of patients with at least one procedural or clinical dispensing error showed signicant reductions of 61% (94% CI 56–66%) and 2% (95% CI 0.7–3.6%). Fifty system‐related prescribing errors were identified. Mean error severity score was minor in both groups. Median patient waiting time for prescription dispensing was reduced by 52% (from 27 to 13 min; p < 0.0001). Conclusion: Implementation of the integrated system significantly reduced prescribing and dispensing errors and patient waiting times for prescription dispensing. Clinicians need to manage new system‐related errors to reduce associated risks.