Impact of Electronic Prescribing on Medication Errors A*

电子处方对用药错误的影响 A*

• 批准号: 6448827
• 负责人: KEVIN B. JOHNSON
• 金额: $ 35.81万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-18 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6448827
• 关键词: clinical research; computer human interaction; health care personnel performance; health service demonstration project; human subject; outpatient care; patient safety /medical error; pediatric pharmacology; pediatrics; personal computers; physicians; clinical research; computer human interaction; health care personnel performance; health service demonstration project; human subject; outpatient care; patient safety /medical error; pediatric pharmacology; pediatrics; personal computers; physicians

DESCRIPTION: Verbatim from the Applicant?s Abstract The Institute of Medicine?s report entitled "To Err is Human" identifies medication errors as an alarming and often preventable cause of patient morbidity and mortality. This report focused on the errors inherent in inpatient practice; however, advocates for child safety recognize the need for pediatric studies in this area. Children pose unique challenges, including increased risk incurred by weight-based dosing, and the potential for more serious consequences. The same challenges inherent in prescribing medications for children may pose difficulty for information systems designed to decrease medication errors. There are no studies examining the potential effects or problems associated with the use of tools for electronic prescribing in the pediatric population. This application proposes to assess the baseline medication error rate in an urban pediatric emergency department and clinic, staffed by attending physicians, fellows, and residents in all years of training. Implements of handheld electronic prescription writing will be compared and the effect that electronic prescribing has on medication error rates and prescribing practices will be determined. The first phase of this project will be an observational study. All patients being seen in the investigators? study sites for acute care who have a way of being contacted after filling their prescriptions will be eligible to be enrolled in this study. Each prescription will be logged, and patients will be contacted to compare the medication label with the original prescription. Any errors will be investigated by a data-monitoring team to determine the source of the error. The second phase of this project will be a randomized, controlled study using both paper-based and handheld electronic prescription writing tools in two pediatric outpatient facilities for two years. Each month, we will assign physicians to two-week blocks to utilize either paper-based or electronic prescribing. Randomization will change the method used by the site, rather than that used by the individual physician. The medication error rate will be determined in a fashion identical to that used during the first phase. At the end of each two-week block, all providers will complete a brief survey to quantify their compliance with recommended prescribing practices. These results will provide important data about the effectiveness of electronic prescription writing tools with respect to decreasing medication errors and improving prescribing practices. These results will be useful to commercial companies building tools to face the unique challenges of pediatrics. Finally, these results will help to guide additional studies about how information technology may improve pediatric patient care.

描述：申请人摘要的逐字 医学研究所的报告标题为“ err是人类” 药物错误是一个令人震惊且通常可以预防的病人的原因 发病率和死亡率。该报告的重点是 住院实践；但是，倡导儿童安全的倡导者认识到需要 该地区的儿科研究。孩子们提出了独特的挑战，包括 基于体重的剂量引起的风险增加，并有可能增加 严重后果。处方药物固有的挑战相同 对于儿童，对于旨在减少的信息系统可能会构成困难 用药错误。没有研究研究潜在影响或 与使用工具用于电子处方有关的问题 小儿种群。 本申请建议评估基线药物错误率 城市儿科急诊科和诊所，由参加 在所有年份的培训中，医师，研究员和居民。工具的 将比较手持电子处方写作和 电子处方对药物错误率和处方惯例有 将确定。 该项目的第一阶段将是一项观察性研究。所有患者 在调查人员中看到？急性护理的研究网站 在填写处方后与之联系有资格 参加了这项研究。每个处方将记录，患者将 联系以将药物标签与原始处方进行比较。 数据监控团队将调查任何错误，以确定 错误来源。该项目的第二阶段将是一个随机的， 使用纸基和手持电子处方的对照研究 在两个儿科门诊设施中编写工具两年。每个 一个月，我们将把医生分配给两周的街区，以利用这两张纸 或电子处方。随机化将改变由 该站点，而不是个人医生使用的网站。药物 错误率将以与在此期间使用的方式相同的方式确定 第一阶段。在每个两周街区的末尾，所有提供商都将完成 简短调查以量化其符合建议的处方 实践。 这些结果将提供有关有效性的重要数据 电子处方书写工具降低药物 错误并改善处方实践。这些结果对 商业公司建立了面对独特挑战的工具 儿科。最后，这些结果将有助于指导其他研究 关于信息技术如何改善儿科患者护理。