title: Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists.
abstract: The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS).
  
  
  
  To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features.
  
  
  
  A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test.
  
  
  
  Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P  <   0.001), allergy checker ( P  =   0.003), treatment protocols ( P  =   0.003), drug-indication mismatch alerts ( P  =   0.031) and prolonged course alerts ( P  =   0.041) and lower priority to a dose checker for adults ( P  =   0.02) and an interaction checker ( P  <   0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure.
  
  
  
  The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS.
authors.affiliation: Southampton Pharmacy Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.|Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Kieran S
authors.initials: KS
authors.lastname: Hand
authors.affiliation: Pharmacy Department, St Mary's Hospital, Parkhurst Road, Newport, Isle of Wight PO31 7QJ, UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Cumming
authors.affiliation: Department of Infectious Diseases & Microbiology, Royal Free London NHS Foundation Trust, Pond St, London NW3 2QG, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Hopkins
authors.affiliation: Southampton Statistical Sciences Research Institute, University of Southampton, University Road, Southampton SO17 1BJ, UK.
authors.forename: Sean
authors.initials: S
authors.lastname: Ewings
authors.affiliation: Southampton Pharmacy Research Centre, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.|Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: Fox
authors.affiliation: Microbiology Department, St Mary's Hospital, Parkhurst Road, Newport, Isle of Wight PO31 7QJ, UK.
authors.forename: Sandya
authors.initials: S
authors.lastname: Theminimulle
authors.affiliation: Department of Microbiology, Royal Devon and Exeter NHS Foundation Trust, Church Lane, Heavitree, Exeter EX2 5AD, UK.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Porter
authors.affiliation: Pharmacy Department, Hampshire Hospitals NHS Foundation Trust, Royal Hampshire County Hospital, Romsey Road, Winchester SO22 5DG, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Parker
authors.affiliation: Pharmacy Department, Western Sussex Hospitals NHS Foundation Trust, St Richards Hospital, Chichester PO19 6SE, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Munns
authors.affiliation: Pharmacy Department, Queen Alexandra Hospital, Southwick Hill Road, Portsmouth Hospitals' NHS Trust, Portsmouth PO6 3LY, UK.
authors.forename: Adel
authors.initials: A
authors.lastname: Sheikh
authors.affiliation: Pharmacy Department, Hampshire Hospitals NHS Foundation Trust, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke RG24 9NA, UK.
authors.forename: Taryn
authors.initials: T
authors.lastname: Keyser
authors.affiliation: City Hospital, Institute of Public Health, Nottingham NG5 1PB, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Puleston
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D017723:Drug Utilization Review; D055695:Electronic Prescribing; D019538:Health Care Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D055552:Infectious Disease Medicine; D061214:Patient Safety; D010595:Pharmacists; D011795:Surveys and Questionnaires
chemical_list: D000890:Anti-Infective Agents