Electronic Prescribing--Medication Errors in Pediatrics

电子处方——儿科用药错误

• 批准号: 6658032
• 负责人: KEVIN B. JOHNSON
• 金额: $ 31.01万
• 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 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6658032
• 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

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：申请人摘要的逐字记录 医学研究所题为“人都会犯错”的报告指出 用药错误是导致患者死亡的一个令人担忧且通常可以预防的原因 发病率和死亡率。该报告重点关注了固有的错误 住院实习；然而，儿童安全倡导者认识到需要 该领域的儿科研究。儿童面临着独特的挑战，包括 基于体重的剂量带来的风险增加，并且有可能发生更多 造成严重后果。处方药物也面临同样的挑战 对于儿童来说可能会给旨在减少信息系统的困难 用药错误。没有研究检验潜在影响或 与使用电子处方工具相关的问题 儿科人群。 该应用程序建议评估基线用药错误率 城市儿科急诊科和诊所，配备主治医生 医生、研究员和住院医生在所有年份的培训中。实现了 手持式电子处方书写效果对比 电子处方对用药错误率和处方实践有影响 将被确定。 该项目的第一阶段将是一项观察性研究。所有患者 被调查人员看到？急性护理研究中心谁有办法 在配药后被联系将有资格 参加了这项研究。每个处方都会被记录下来，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 错误的来源。该项目的第二阶段将是随机的， 使用纸质和手持式电子处方进行对照研究 在两个儿科门诊机构使用书写工具已有两年。每个 月，我们将分配医生为期两周的时间段，以使用纸质 或电子处方。随机化将改变所使用的方法 该网站，而不是个别医生使用的网站。药物 错误率将以与期间使用的方式相同的方式确定 第一阶段。在每两周的区块结束时，所有提供商都将完成一份 简短的调查以量化他们对建议处方的遵守情况 做法。 这些结果将提供有关有效性的重要数据 减少用药的电子处方书写工具 错误并改进处方实践。这些结果将有助于 商业公司构建工具来应对独特的挑战 儿科。最后，这些结果将有助于指导进一步的研究 关于信息技术如何改善儿科患者护理。