The effect of computer-assisted prescription writing on emergency department prescription errors.
OBJECTIVE
To determine whether computer-assisted prescription writing reduces the frequency of prescription errors in the emergency department (ED).


METHODS
A pre-post retrospective analysis was used to compare errors between handwritten (HW) and computer-assisted (CA) ED prescriptions. Prescriptions were reviewed for pharmacist clarifications. A clarification was defined as an error if missing information, incorrect information, incorrect dose, non-formulary medication, or illegibility was the reason for clarification. The HW and CA error rates were compared using odds ratios (ORs) with 95% confidence intervals (95% CIs).


RESULTS
During the pre-intervention period, there were 7,036 patient visits with 2,326 HW ED prescriptions filled for 1,459 patients. There were 91 clarifications, with a rate of 3.9%. There were 54 HW errors, for an error rate of 2.3%. During the post-intervention period, there were 7,845 patient visits with 1,594 CA prescriptions filled for 1,056 patients. There were 13 clarifications, with a clarification rate of 0.8%, and 11 errors, for a CA error rate of 0.7%. The CA prescriptions were substantially less likely to contain an error [OR 0.31 (95% CI = 0.10 to 0.36)] or to require pharmacist clarification [OR 0.19 (95% CI = 0.10 to 0.36)] than were the HW prescriptions.


CONCLUSIONS
Computer-assisted prescriptions were more than three times less likely to contain errors and five times less likely to require pharmacist clarification than handwritten prescriptions.
Bizovi
Kenneth E
KE
Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 97201, USA. bizovik@ohsu.edu
Beckley
Brandon E
BE
McDade
Michelle C
MC
Adams
Annette L
AL
Lowe
Robert A
RA
Zechnich
Andrew D
AD
Hedges
Jerris R
JR
D016303:Clinical Pharmacy Information Systems; D011307:Drug Prescriptions; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006784:Hospitals, Teaching; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital; D009922:Oregon; D010607:Pharmacy Service, Hospital