Advertisement

Pharmacy World and Science

, Volume 27, Issue 4, pp 351–352 | Cite as

Medication Errors in an Internal Medicine Department. Evaluation of a Computerized Prescription System

  • Ana MircoEmail author
  • Luís Campos
  • Fátima Falcão
  • João Silva Nunes
  • Ana Aleixo
Short Research Article

Abstract

Objective: Evaluation of a computerized physician order entry in an Internal Medicine Department, with a unit-dose distribution system.

Setting: Pharmacy Department, Internal Medicine Department. S. Francisco Xavier Hospital, Lisbon, Portugal.

Method: This study was carried out in December 2001 and January 2002. After two years experience of the CPOE system, medication errors were evaluated prospectively, in an internal medical department of a 360-bed academic hospital. Data were collected once a week. Pharmacists reviewed all medical prescriptions as part of their routine work. Medication errors detected were recorded on a data collection form with a design based on the types of errors as defined by the American Society of Hospital Pharmacists (ASHP). Completed forms were reviewed and medication errors were classed according to ASHP guidelines.

Results: A total of 2268 orders were monitored (162 patients). In these orders, 73 medication errors (22.4% of the patients) were detected and documented (59 prescribing errors and 14 monitoring errors). The most common prescribing errors were deficiencies related to the right class but wrong drug (28.3%): omeprazole vs. ranitidine/sucralfate in stress ulcer prophylaxis; incorrect dose (30%) and unclear orders (13.3%). Errors related to incorrect frequency of administration (5%); maintenance of IV route (5%); duplicated drug therapy (11.7%); drug interactions (1.7%) and length of therapy (3.3%) were also detected. The 14 monitoring errors detected were failures to review a prescribed regimen for appropriateness and detection of problems.

Conclusions: Computerized prescription order entry has demonstrated effectiveness in eliminating medication errors related to transcribing and patient identification. Nevertheless, medication errors related to prescription and monitoring still occur. The use of clinical decision support systems and pharmacist involvement is vital to achieve maximum medication safety and reduce medication error rates.

Key words

CPOE Hospital Medication orders Pharmacists Portugal Prescribing errors Prescription entry 

References

  1. 1.
    Kaushal, R,  et al. 2003Effects of computerizes physician order entry and clinical decision support systems on medication safety A systematic reviewArch Intern Med163140916CrossRefPubMedGoogle Scholar
  2. 2.
    Wesbit, T. 2001Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice modelAm J Health Syst Pharm5878490PubMedGoogle Scholar
  3. 3.
    American Society of Hospital Pharmacists. ASHP guidelines on preventing medication errors in hospitals. Am J Hosp Pharm 1993; 50:305–14Google Scholar
  4. 4.
    Bobb, A, Gleason, K,  et al. 2004The epidemiology of prescribing errorsThe potential impact of computerized prescriber order entry. Arch Intern Med16478592Google Scholar
  5. 5.
    Graber, M. 2004The safety of computer-based medication systemsArch Intern Med16433940CrossRefPubMedGoogle Scholar
  6. 6.
    Carmenates, J. 2001Impact of automation on pharmacist interventions and medication errors in a correction health care systemAm J Health Syst Pharm5877983PubMedGoogle Scholar
  7. 7.
    Second Consensus of Granada on Drug Therapy Problems. Ars Pharmaceutica 2002; 43(3–4):175–84Google Scholar
  8. 8.
    Norton, L. 2001Continuing education – medical and medication errors: a partial summary of reports by the Institute of Medicine and the Quality Interagency Coordination Task ForceJ Manage Care Pharm7628Google Scholar
  9. 9.
    Ellis, SL. 2000Types of interventions made by clinical pharmacists in the IMPROVE StudyPharmacotherapy2042935CrossRefPubMedGoogle Scholar
  10. 10.
    Bond, CA. 2000Medications errors in the United States HospitalsPharmacotherapy21102336Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Ana Mirco
    • 1
    Email author
  • Luís Campos
    • 1
  • Fátima Falcão
    • 1
  • João Silva Nunes
    • 1
  • Ana Aleixo
    • 1
  1. 1.Hospital de S. Francisco XavierServiços FarmacêuticosLisboaPortugal

Personalised recommendations