Impact of computerised chemotherapy prescriptions on the prevention of medication errors.
OBJECTIVE
The authors sought to evaluate the impact of computerised chemotherapy prescription on the reduction of medication errors. The purpose of this study was to assess the incidence of errors present in electronic versus manual prescription.


METHODS
The data gathered from computerised chemotherapy prescription sheets were submitted to a prospective analysis as cases of the intervention groups. The control group was comprised of the handwritten chemotherapy prescription sheets. Chemotherapy prescriptions for consecutive oncology patients were analysed by 2 independent examiners, who investigated errors of omission, commission, interpretation of dates, abbreviations and illegible handwriting. The proportion of treatment prescriptions containing one or more errors and the median of errors were calculated in order in both groups.


RESULTS
At least one error was detected in 100% of the manual prescriptions and in 13% of computerised prescriptions (p < 0.001). The median of errors per computerised prescription was 0 (range: 0- 1), whereas in manual prescriptions the median was 5 (range: 1-12) (p < 0.001). Errors of omission were predominant in manual prescriptions. Errors of commission were limited to 1 case of unjustified cytostatic agent infra-dosage in a computerised prescription. This error was present in 3 cases in handwritten prescriptions and, in addition, 1 case of premedication drug substitution was detected. Errors of interpretation of the date, use of abbreviations and illegible handwriting were frequent among manual prescriptions and were absent from computerised prescriptions.


CONCLUSIONS
Electronic chemotherapy prescription is a powerful tool. In this study it has been shown to decrease chemotherapy-related medication errors and ensure that safe chemotherapy practices were followed.
Huertas Fernández
María J
MJ
Pharmacy Clinical Management Unit. Puerta del Mar University Hospital. Cádiz. Spain. josem.baena.sspa@juntadeandalucia.es
Baena-Cañada
José M
JM
Martínez Bautista
María J
MJ
Arriola Arellano
Esperanza
E
García Palacios
María Victoria
MV
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011307:Drug Prescriptions; D006236:Handwriting; D006748:Hospital Departments / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D008495:Medical Oncology / Q000706:statistics & numerical data; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D011932:Reading; D013030:Spain
D000970:Antineoplastic Agents