Implementation of rules based computerised bedside prescribing and administration: intervention study.
OBJECTIVE
To implement and assess a rules based computerised prescribing system with the aim of improving the safety of prescriptions and the administration of drugs.


METHODS
Analysis of performance of computerised system plus questionnaire survey of users.


METHODS
64 bed renal unit in a teaching hospital.


METHODS
: Introduction of the system into routine clinical use.


METHODS
Number of attempted prescriptions cancelled by the system; proportion of warning messages overridden; users' comparisons of the system with conventional procedures.


RESULTS
Between October 1998 and August 1999 the system cancelled 58 (0.07%) out of 87 789 prescriptions on the grounds of clinical safety. In addition, 427 (57%) attempted prescriptions generating high level warnings and 1257 (8%) generating low level warnings were not completed. In a user survey 82% (31/38) of doctors and nurses considered the system to be an improvement on conventional procedures.


CONCLUSIONS
The system has contributed to safety and patient care. All prescriptions are complete and legible, and transcription errors have been eliminated. The system assists clinicians when they are writing a prescription by making available information on patients. The system supports clinical decision making and has been well received by doctors, nurses, and pharmacists.
Nightingale
P G
PG
Wolfson Computer Laboratory, Department of Medicine, University of Birmingham, Queen Elizabeth Medical Centre, Birmingham B15 2TH. P.G.Nightingale@bham.ac.uk
Adu
D
D
Richards
N T
NT
Peters
M
M
D004360:Drug Therapy, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D019095:Point-of-Care Systems