scholarly journals Characteristics of pharmacist’s interventions triggered by prescribing errors related to computerised physician order entry in French hospitals: a cross-sectional observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045778
Author(s):  
Manon Videau ◽  
Bruno Charpiat ◽  
Céline Vermorel ◽  
Jean-Luc Bosson ◽  
Ornella Conort ◽  
...  
Keyword(s):  
Observational Study ◽  
Acceptance Rate ◽  
Drug Related Problems ◽  
Prescribing Errors ◽  
Order Entry ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Clinical Consequences ◽  
Physician Order Entry ◽  
Certified Software

ObjectivesComputerised physician order entry (CPOE) systems facilitate the review of medication orders by pharmacists. Reports have emerged that show conception flaws or the misuse of CPOE systems generate prescribing errors. We aimed to characterise pharmacist interventions (PIs) triggered by prescribing errors identified as system-related errors (PISREs) in French hospitals.DesignThis was a cross-sectional observational study based on PIs prospectively documented in the Act-IP observatory database from January 2014 to December 2018.SettingPISREs from 319 French computerised healthcare facilities were analysed.ParticipantsAmong the 319 French hospitals, 232 (72.7%) performed SRE interventions, involving 652 (51%) pharmacists.ResultsAmong the 331 678 PIs recorded, 27 058 were qualified as due to SREs (8.2%). The main drug-related problems associated with PISREs were supratherapeutic (27.5%) and subtherapeutic dosage (17.2%), non-conformity with guidelines/contraindications (22.4%) and improper administration (17.9%). The PI prescriber acceptation rate was 78.9% for SREs vs 67.6% for other types of errors. The PISRE ratio was estimated relative to the total number of PIs. Concerning the certification status of CPOE systems, the PISRE ratio was 9.4% for non-certified systems vs 5.5% for certified systems (p<0.001). The PISRE ratio for senior pharmacists was 9.2% and that for pharmacy residents 5.4% (p<0.001). Concerning prescriptions made by graduate prescribers and those made by residents, the PISRE ratio was 8.4% and 7.8%, respectively (p<0.001).ConclusionComputer-related prescribing errors are common. The PI acceptance rate by prescribers was higher than that observed for PIs that were not CPOE related. This suggests that physicians consider the potential clinical consequences of SREs for patients to be more frequently serious than interventions unrelated to CPOE. CPOE medication review requires continual pharmacist diligence to catch these errors. The significantly lower PISRE ratio for certified software should prompt patient safety agencies to undertake studies to identify the safest software and discard software that is potentially dangerous.

scholarly journals A Methodological Assessment of Pharmacist Therapeutic Intervention Documentation (TID) in a Single Tertiary Care Hospital in Jeddah, Kingdom of Saudi Arabia

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 97
Author(s):  
Ali F. Alwadie ◽  
Anjum Naeem ◽  
Meaad A. Almazmomi ◽  
Meshail A. Baswaid ◽  
Yahya A. Alzahrani ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Pharmacist Intervention ◽  
Study Data ◽  
Real Problem ◽  
Care Hospital ◽  
Prescribing Errors ◽  
Order Entry ◽  
Cross Sectional ◽  
Methodological Assessment ◽  
Physician Order Entry

Pharmacist intervention has valuable input to the healthcare system by reducing medication errors, costs of treatment and improving therapeutic outcomes. This study aimed to analyze pharmacists’ interventions during the verification of computerized physician order entry and to determine the association between prescribers’ level and type of prescribing errors. In this cross-sectional, observational study, data collection was carried out over three months starting from 1 January 2020 to 31 March 2020. Included were 2405 interventions documented by 52 different pharmacists. The prevalence of prescribing order entry errors was 9.1%. The most identifiable type of intervention was incorrect dilution (40.2%) followed by dose substitution (27.7%). The drug category associated with a high percentage of interventions was perfusion solutions (41%), followed by antibacterial (35%). The number of junior physician orders that required pharmacist intervention was higher than other prescribers (45.2%), followed by specialist and senior physicians, (31.4% and 15.5%, respectively). Prescriber ordering time and types of prescribing errors were shown to have a significant (p < 0.05) association. Internal medicine physicians entered the highest percentage of prescribing errors, representing 22.7%. The current study concluded that TID has significant potential to reduce drug-related problems; TID fatigue is a real problem that might be under-reported and addressing this point in future studies would be of great value.

scholarly journals Role of Computerized Physician Order Entry Usability in the Reduction of Prescribing Errors

2013 ◽  
Vol 19 (2) ◽  
pp. 93 ◽  
Author(s):  
Hamid Reza Peikari ◽  
Mohamad Shanudin Zakaria ◽  
Norjaya M. Yasin ◽  
Mahmood Hussain Shah ◽  
Abdelbary Elhissi
Keyword(s):  
Computerized Physician Order Entry ◽  
Prescribing Errors ◽  
Order Entry ◽  
Physician Order Entry

Effect of computerized physician order entry in the prescribing errors in inpatient care in a pulmonology unit

2015 ◽  
Author(s):  
Elena Villamañán ◽  
Aldara García-Sánchez ◽  
Ester Zamarron ◽  
Eduardo Armada ◽  
Yolanda Larrubia ◽  
...  
Keyword(s):  
Inpatient Care ◽  
Computerized Physician Order Entry ◽  
Prescribing Errors ◽  
Order Entry ◽  
Physician Order Entry

scholarly journals Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study

2014 ◽  
Vol 26 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Renata Rego Lins Fumis ◽  
Eduardo Leite Vieira Costa ◽  
Paulo Sergio Martins ◽  
Vladimir Pizzo ◽  
Ivens Augusto Souza ◽  
...  
Keyword(s):  
Survey Study ◽  
Computerized Physician Order Entry ◽  
Order Entry ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Physician Order Entry

Medication prescribing errors: a pre- and post-computerized physician order entry retrospective study

2018 ◽  
Vol 41 (1) ◽  
pp. 228-236 ◽  
Author(s):  
Naïs Rouayroux ◽  
Violaine Calmels ◽  
Bérengére Bachelet ◽  
Brigitte Sallerin ◽  
Elodie Divol
Keyword(s):  
Retrospective Study ◽  
Computerized Physician Order Entry ◽  
Prescribing Errors ◽  
Order Entry ◽  
Medication Prescribing ◽  
Physician Order Entry

scholarly journals A qualitative study of prescribing errors among multi-professional prescribers within an e-prescribing system

2020 ◽  
Author(s):  
Fahad Alshahrani ◽  
John F. Marriott ◽  
Anthony R. Cox
Keyword(s):  
Qualitative Study ◽  
Qualitative Interviews ◽  
Unintended Consequences ◽  
Electronic Prescribing ◽  
Prescribing Errors ◽  
Environmental Aspects ◽  
Order Entry ◽  
Contributing Factors ◽  
Prescribing Error ◽  
Physician Order Entry

Abstract Background Computerised Physician Order Entry (CPOE) is considered to enhance the safety of prescribing. However, it can have unintended consequences and new forms of prescribing error have been reported. Objective The aim of this study was to explore the causes and contributing factors associated with prescribing errors reported by multidisciplinary prescribers working within a CPOE system. Main Outcome Measure Multidisciplinary prescribers experience of prescribing errors in an CPOE system. Method This qualitative study was conducted in a hospital with a well-established CPOE system. Semi-structured qualitative interviews were conducted with prescribers from the professions of pharmacy, nursing, and medicine. Interviews analysed using a mixed inductive and deductive approach to develop a framework for the causes of error. Results Twenty-three prescribers were interviewed. Six main themes influencing prescribing were found: the system, the prescriber, the patient, the team, the task of prescribing and the work environment. Prominent issues related to CPOE included, incorrect drug name picking, default auto-population of dosages, alert fatigue and remote prescribing. These interacted within a complex prescribing environment. No substantial differences in the experience of CPOE were found between the professions. Conclusion Medical and non-medical prescribers have similar experiences of prescribing errors when using CPOE, aligned with existing published literature about medical prescribing. Causes of electronic prescribing errors are multifactorial in nature and prescribers describe how factors interact to create the conditions errors. While interventions should focus on direct CPOE issues, such as training and design, socio-technical, and environmental aspects of practice remain important.

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