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| 094P London, UK Pharmacology 2016 |
Which is safer - manual or electronic prescribing? A clinic audit assessing the errors made on inpatient drug charts following the introduction of electronic prescribing
Background and Aims: Prescribing errors are common, with systematic reviews suggesting that up to 9% of medication orders in hospitals contain at least one error1. Studies have shown that implementation of e-prescribing systems have resulted in significant reductions in prescribing error rates of up to 55%2. The aims of this audit were to assess the impact of electronic prescribing on the quality of inpatient prescriptions and to identify problems associated with the implementation of a new prescribing system.
Summary of work and outcomes: The work involved assessing 60 paper and 60 electronic prescriptions from a variety of medical and surgical inpatient wards. These charts were analysed against an audit tool which focused on the quality of the prescriptions made and whether the charts had been completed correctly. Outcomes were assessed by evaluating the adherence of the two prescribing systems to the audit standards which were based on the hospital’s medicines policy. Overall electronic prescribing adhered to the audit standards more than paper prescribing and increased the quality of drug prescriptions.
Discussion: This audit highlights the benefits of electronic prescribing in terms of the quality of prescriptions made and opens up the possibility of assessing and improving the overall safety of e-prescribing systems e.g. ability to recognise dangerous interactions and overdoses. This audit has not only identified problems in the digital maturity of the e-prescribing system but with the users themselves. There is currently no formal curriculum aimed at the education of medical students in the use of e-prescribing systems. If this is to be the future of prescribing in secondary care, the curriculum will need to be modified as well as the prescribing safety assessment.
Conclusion: This audit demonstrates the impact of the implementation of electronic prescribing systems within a secondary care setting and what educational improvements can be made to accommodate for this change.
References
1. Dornan T, Ashcroft D, Heathfield H et al. (2009). An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study.
Available: http://www.gmcuk.org/FINAL_Report_prevalence_and_causes_of_prescribing_errors.pdf_28935150.pdf. Last accessed 30/12/2015.
2. Westbrook J, Reckmann M, Li L et al. (2012). Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study. PLoS Med. 9 (1), 1001164.