title: Format of medical order sheet improves security of antibiotics prescription: The experience of an intensive care unit.
abstract: OBJECTIVE
  To assess whether formatting the medical order sheet has an effect on the accuracy and security of antibiotics prescription.
  
  
  METHODS
  Prospective assessment of antibiotics prescription over time, before and after the intervention, in comparison with a control ward.
  
  
  METHODS
  The medical and surgical intensive care unit (ICU) of a university hospital.
  
  
  METHODS
  All patients hospitalized in the medical or surgical ICU between February 1 and April 30, 1997, and July 1 and August 31, 2000, for whom antibiotics were prescribed.
  
  
  METHODS
  Formatting of the medical order sheet in the surgical ICU in 1998.
  
  
  RESULTS
  Compliance with the American Society of Hospital Pharmacists' criteria for prescription safety was measured. The proportion of safe orders increased in both units, but the increase was 4.6 times greater in the surgical ICU (66% vs. 74% in the medical ICU and 48% vs. 74% in the surgical ICU). For unsafe orders, the proportion of ambiguous orders decreased by half in the medical ICU (9% vs. 17%) and nearly disappeared in the surgical ICU (1% vs. 30%). The only missing criterion remaining in the surgical ICU was the drug dose unit, which could not be preformatted. The aim of antibiotics prescription (either prophylactic or therapeutic) was indicated only in 51% of the order sheets.
  
  
  CONCLUSIONS
  Formatting of the order sheet markedly increased security of antibiotics prescription. These findings must be confirmed in other settings and with different drug classes. Formatting the medical order sheet decreases the potential for prescribing errors before full computerized prescription is available.
authors.affiliation: Medical Direction, Department of Medicine, University Hospital, Lausanne, Switzerland.
authors.forename: Jean-Blaise
authors.initials: JB
authors.lastname: Wasserfallen
authors.forename: Anne-Joëlle
authors.initials: AJ
authors.lastname: Bütschi
authors.forename: Patrik
authors.initials: P
authors.lastname: Muff
authors.forename: Jérôme
authors.initials: J
authors.lastname: Biollaz
authors.forename: Marie-Denise
authors.initials: MD
authors.lastname: Schaller
authors.forename: André
authors.initials: A
authors.lastname: Pannatier
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Revelly
authors.forename: René
authors.initials: R
authors.lastname: Chiolero
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions; D005568:Forms and Records Control; D006801:Humans; D007362:Intensive Care Units; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D013557:Switzerland
chemical_list: D000900:Anti-Bacterial Agents