Electronic prescribing reduced prescribing errors in a pediatric renal outpatient clinic.
OBJECTIVE
To assess the effect of an electronic prescribing (EP) system on the incidence and type of prescribing errors and the number of error-free visits.


METHODS
This was a before-and-after study conducted in a nephrology outpatient clinic at an acute tertiary care pediatric hospital.


RESULTS
A total of 520 patients had 2242 items prescribed on 1141 prescriptions during the study period. The overall prescribing error rate was 77.4% (95% confidence interval [CI] = 75.3% to 79.4%) for handwritten items and 4.8% (95% CI = 3.4% to 6.7%) with EP. Before EP, 1153 (73.3%; 95% CI = 71.1% to 75.4%) items were missing essential information, and 194 (12.3%; 95% CI = 10.8% to 14%) were judged illegible. After EP, only 9 (1.4%; 95% CI = 0.7% to 2.6%) items were missing essential information, and illegibility errors were eliminated. The number of patient visits that were error-free increased from 21% to 90% (69% difference; 95% CI = 64% to 73.4%) after the implementation of EP.


CONCLUSIONS
There was a high incidence of errors using handwritten prescriptions in the outpatient setting, with an overall error rate of 77.4%. EP significantly reduced errors related to completeness of prescriptions and eliminated legibility related errors.
Jani
Yogini Hariprasad
YH
Centre for Pediatric Pharmacy Research, The School of Pharmacy, University of London and the Institute of Child Health, University College London, London, UK.
Ghaleb
Maisoon Abdullah
MA
Marks
Stephen D
SD
Cope
Judith
J
Barber
Nick
N
Wong
Ian Chi Kei
IC
D000368:Aged; D000554:Ambulatory Care Facilities; D000555:Ambulatory Care Information Systems; D002648:Child; D016303:Clinical Pharmacy Information Systems; D003661:Decision Support Techniques; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D050316:Medical Order Entry Systems; D008508:Medication Errors; D008509:Medication Systems; D008875:Middle Aged; D009398:Nephrology / Q000379:methods*; D010372:Pediatrics / Q000379:methods*; D010607:Pharmacy Service, Hospital; D015203:Reproducibility of Results