J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems.

Tópicos

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Resumo

JECTIVE: To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them.MATERIALS AND METHODS: This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system.RESULTS: Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors).DISCUSSION: About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others.CONCLUSIONS: Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors.

Resumo Limpo

jectiv report frequenc type caus error associ outpati computergener prescript develop framework classifi error determin strategi greatest potenti prevent themmateri method retrospect cohort studi computergener prescript receiv commerci outpati pharmaci chain across three state week clinician panel review prescript use previous describ method identifi classifi medic error primari outcom incid medic error potenti advers drug event defin error potenti harm rate prescrib error error type prescrib systemresult prescript contain total error consid potenti advers drug event error rate vari computer prescrib system common error omit inform errorsdiscuss one computergener prescript includ least one error third potenti harm consist literatur manual handwritten prescript error rate number type sever error vari computer prescrib system suggest system may better prevent error othersconclus implement computer prescrib system without comprehens function process place ensur meaning system use decreas medic error author offer target recommend improv computer prescrib system prevent error

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