title: Prevention of prescription errors by computerized, on-line surveillance of drug order entry.
abstract: OBJECTIVE
  The present study was undertaken to quantify the impact of computerized drug order entry system (CDOE) connected to the patients' database, on the incidence and type of prescription errors (PEs) in the medical service, and to delineate the causes for remaining errors.
  
  
  METHODS
  Drug orders were reviewed daily by a physician-reviewer, in a department of internal medicine that used for more than 3 years a CDOE (CDOEdept), and in a similar department in which drug orders were handwritten (HWdept). PEs were divided into those not related to the individual patient (type 1 PEs), and PEs resulting from drug-laboratory, drug-disease, and drug-allergy interactions (type 2 PEs).
  
  
  RESULTS
  Ten thousand and two hospitalization days were evaluated. The incidence of type 1 PEs was 5.21 and 1.36 per 100 hospitalization days in the HWdept and CDOEdept, respectively (p<0.0001). Type 2 PEs were more common, 7.20 and 3.02 per 100 hospitalization days in the HWdept and CDOEdept, respectively (p<0.0001), and about 75% of them were due to few drug-laboratory interactions. Most of the remaining errors in the CDOEdept were due to inadequate adjustment of drugs and doses to renal function, or failure to perform adequate changes when new laboratory results became available.
  
  
  CONCLUSIONS
  We conclude that linking the CDOE with few, specific, laboratory results has a large impact on the prevention of PEs. Combining the CDOE with a drug-laboratory alert system is expected to further reduce the incidence of PEs.
authors.affiliation: Department of Medicine B, Bnai Zion Medical Center, Rappaport School of Medicine, Technion, Haifa, Israel. oliven@techunix.technion.ac.il
authors.forename: Arie
authors.initials: A
authors.lastname: Oliven
authors.forename: Irena
authors.initials: I
authors.lastname: Michalake
authors.forename: Daniela
authors.initials: D
authors.lastname: Zalman
authors.forename: Evgenia
authors.initials: E
authors.lastname: Dorman
authors.forename: Dan
authors.initials: D
authors.lastname: Yeshurun
authors.forename: Majed
authors.initials: M
authors.lastname: Odeh
mesh_terms: D000046:Academic Medical Centers; D016907:Adverse Drug Reaction Reporting Systems; D016303:Clinical Pharmacy Information Systems; D011307:Drug Prescriptions; D006801:Humans; D007557:Israel; D008485:Medical Audit; D008508:Medication Errors / Q000517:prevention & control*