Format of medical order sheet improves security of antibiotics prescription: The experience of an intensive care unit.
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.
Wasserfallen
Jean-Blaise
JB
Medical Direction, Department of Medicine, University Hospital, Lausanne, Switzerland.
Bütschi
Anne-Joëlle
AJ
Muff
Patrik
P
Biollaz
Jérôme
J
Schaller
Marie-Denise
MD
Pannatier
André
A
Revelly
Jean-Pierre
JP
Chiolero
René
R
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
D000900:Anti-Bacterial Agents