title: [Failure mode and effects analysis on computerized drug prescriptions].
abstract: OBJECTIVE
  To identify and analyze errors in drug prescriptions of patients treated in a "high resolution" hospital by applying a Failure mode and effects analysis (FMEA).Material and methods A multidisciplinary group of medical specialties and nursing analyzed medical records where drug prescriptions were held in free text format. An FMEA was developed in which the risk priority index (RPI) was obtained from a cross-sectional observational study using an audit of the medical records, carried out in 2 phases: 1) Pre-intervention testing, and (2) evaluation of improvement actions after the first analysis. An audit sample size of 679 medical records from a total of 2,096 patients was calculated using stratified sampling and random selection of clinical events.
  
  
  RESULTS
  Prescription errors decreased by 22.2% in the second phase. FMEA showed a greater RPI in "unspecified route of administration" and "dosage unspecified", with no significant decreases observed in the second phase, although it did detect, "incorrect dosing time", "contraindication due to drug allergy", "wrong patient" or "duplicate prescription", which resulted in the improvement of prescriptions.
  
  
  CONCLUSIONS
  Drug prescription errors have been identified and analyzed by FMEA methodology, improving the clinical safety of these prescriptions. This tool allows updates of electronic prescribing to be monitored. To avoid such errors would require the mandatory completion of all sections of a prescription.
authors.affiliation: Departamento de Hospitalización, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España. Electronic address: japaredes22@hotmail.com.
authors.forename: J A
authors.initials: JA
authors.lastname: Paredes-Atenciano
authors.affiliation: F. E. en Cirugía General, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: J P
authors.initials: JP
authors.lastname: Roldán-Aviña
authors.affiliation: F.E. de Farmacia Hospitalaria, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: Mercedes
authors.initials: M
authors.lastname: González-García
authors.affiliation: Departamento de Hospitalización, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: M C
authors.initials: MC
authors.lastname: Blanco-Sánchez
authors.affiliation: Departamento de Enfermería Bloque Quirúrgico, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: M A
authors.initials: MA
authors.lastname: Pinto-Melero
authors.affiliation: Servicio de Anestesiología, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: C
authors.initials: C
authors.lastname: Pérez-Ramírez
authors.affiliation: F. E. en Ginecología, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Calvo Rubio-Burgos
authors.affiliation: Departamento de Urgencias, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir) , Écija, Sevilla, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Osuna-Navarro
authors.affiliation: F.E. de Urgencias, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Jurado-Carmona
mesh_terms: D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards*; D055695:Electronic Prescribing; D000067495:Healthcare Failure Mode and Effect Analysis; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D010355:Patient Identification Systems; D061214:Patient Safety; D062606:Tertiary Care Centers
keywords: Análisis modal de fallos y efectos; Calidad; Drug prescription errors; Electronic medical records; Error de prescripción del medicamento; Failure modes and effects analysis; Historia clínica electrónica; Patient safety; Quality of health care; Seguridad