The Journal of Pediatrics
Volume 152, Issue 2 , Pages 214-218, February 2008

Electronic Prescribing Reduced Prescribing Errors in a Pediatric Renal Outpatient Clinic

  • Yogini Hariprasad Jani, MSc

      Affiliations

    • Centre for Pediatric Pharmacy Research, The School of Pharmacy, University of London and the Institute of Child Health, University College London, London, UK
    • Department of Practice and Policy, The School of Pharmacy, University of London, London, UK
    • Y.J. receives funding for a PhD studentship from Great Ormond Street Hospital for Children, First Databank Europe Ltd, and JAC Computer Systems Ltd. These companies did not contribute to study design; the collection, analysis or interpretation of the data; or writing the manuscript or the decision to submit it for publication.
    • Corresponding Author InformationReprint requests: Yogini Jani, Centre for Pediatric Pharmacy Research, The School of Pharmacy, University of London, Mezzanine, BMA House, Tavistock Square, London, WC1H 9JP, UK.
    • ,
  • Maisoon Abdullah Ghaleb, PhD

      Affiliations

    • Department of Practice and Policy, The School of Pharmacy, University of London, London, UK
    • ,
  • Stephen D. Marks, FRCPCH

      Affiliations

    • Great Ormond Street Hospital for Children NHS Trust, London, UK.
    • ,
  • Judith Cope, MSc

      Affiliations

    • Centre for Pediatric Pharmacy Research, The School of Pharmacy, University of London and the Institute of Child Health, University College London, London, UK
    • Great Ormond Street Hospital for Children NHS Trust, London, UK.
    • ,
  • Nick Barber, PhD

      Affiliations

    • Department of Practice and Policy, The School of Pharmacy, University of London, London, UK
    • ,
  • Ian Chi Kei Wong, PhD

      Affiliations

    • Centre for Pediatric Pharmacy Research, The School of Pharmacy, University of London and the Institute of Child Health, University College London, London, UK
    • Department of Practice and Policy, The School of Pharmacy, University of London, London, UK
    • I.W. has received funding from the UK Medical Research Council and UK Department of Health in the research of medication errors and the use of technology in their reduction.

Received 10 July 2007; received in revised form 6 September 2007; accepted 20 September 2007. published online 19 November 2007.

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.

Study design

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.

Abbreviations: CI, Confidence interval, EP, Electronic prescribing

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PII: S0022-3476(07)00896-7

doi:10.1016/j.jpeds.2007.09.046

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The Journal of Pediatrics
Volume 152, Issue 2 , Pages 214-218, February 2008

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