title: A comparison of educational interventions to improve prescribing by junior doctors.
abstract: BACKGROUND
  Prescribing is a complex task with potential for many types of error to occur. Despite the introduction of a standard national medication chart for Australian hospital inpatients in 2006, simple prescribing errors are common.
  
  
  OBJECTIVE
  To compare the effect of quality improvement initiatives on the rate of simple prescribing errors.
  
  
  METHODS
  A prospective, multisite comparison of prescribing education interventions.
  
  
  METHODS
  Using three hospital sites, we compared site-specific changes in prescribing error rates following use of an online education module alone (low intensity) with prescribing error rates following a high-intensity intervention (comprising the same online education module plus nurse education and academic detailing of junior prescribers). The study period was 4 months between May and August 2011.
  
  
  RESULTS
  Full completion of the adverse drug reactions field did not improve after either intervention; however, there was better documentation of some elements following high-intensity intervention. Prescriber performance improved significantly for more elements in the regular prescription category than any other category of prescription. Legibility of medication name improved across all categories following interventions. Clarity of frequency, prescriber name and documentation of indication improved following both high- and low-intensity intervention.
  
  
  CONCLUSIONS
  Improvements were seen in several prescription elements after the intervention but the majority of elements that improved were affected by both low- and high-intensity interventions. Despite targeted intervention, significant rates of prescribing breaches persisted. The prevalence of prescription breaches partially responds to an online education module. The nature of any additional intervention that would be effective is unclear.
authors.affiliation: From the School of Medicine, University of Adelaide South Australia, 5000, Pharmacy Department, Level 2 East Wing, Royal Adelaide Hospital, 50 North Tce, Adelaide, South Australia 5000, Australia, Flinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia 5042 and School of Medicine, University of Adelaide, South Australia 5000, Australia. Josephine.thomas@health.sa.gov.au.
authors.forename: J S
authors.initials: JS
authors.lastname: Thomas
authors.affiliation: From the School of Medicine, University of Adelaide South Australia, 5000, Pharmacy Department, Level 2 East Wing, Royal Adelaide Hospital, 50 North Tce, Adelaide, South Australia 5000, Australia, Flinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia 5042 and School of Medicine, University of Adelaide, South Australia 5000, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Gillard
authors.affiliation: From the School of Medicine, University of Adelaide South Australia, 5000, Pharmacy Department, Level 2 East Wing, Royal Adelaide Hospital, 50 North Tce, Adelaide, South Australia 5000, Australia, Flinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia 5042 and School of Medicine, University of Adelaide, South Australia 5000, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Khor
authors.affiliation: From the School of Medicine, University of Adelaide South Australia, 5000, Pharmacy Department, Level 2 East Wing, Royal Adelaide Hospital, 50 North Tce, Adelaide, South Australia 5000, Australia, Flinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia 5042 and School of Medicine, University of Adelaide, South Australia 5000, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Hakendorf
authors.affiliation: From the School of Medicine, University of Adelaide South Australia, 5000, Pharmacy Department, Level 2 East Wing, Royal Adelaide Hospital, 50 North Tce, Adelaide, South Australia 5000, Australia, Flinders Centre for Epidemiology and Biostatistics, Flinders University, Bedford Park, South Australia 5042 and School of Medicine, University of Adelaide, South Australia 5000, Australia.
authors.forename: C H
authors.initials: CH
authors.lastname: Thompson
mesh_terms: D001315:Australia; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education*; D008508:Medication Errors; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care