The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study
BMJ Quality & SafetyPublished 1 August 2007Open access
Bryony Dean Franklin, Kerry-Ann O’Grady, Parastou Donyai, Ann Jacklin, Nick Barber
Citations313
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration, and time spent on medication-related tasks increased.
Abstract
A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.
Keywords
MedicineHealth Professions
National Academies Press eBooksTo Err Is Human
14,096 Citations2000Institute of Medicine
A process for the preparation of prostaglandins which are known pharmaceutically active compounds and then R alpha , R omega -cyclopentenoids is described.
JAMAEffect of Computerized Physician Order Entry and a Team Intervention on Prevention of Serious Medication Errors
2,091 Citations1998David W. Bates
Physician computer order entry decreased the rate of nonintercepted serious medication errors by more than half, although this decrease was larger for potential ADEs than for errors that actually resulted in an ADE.
Journal of the American Medical Informatics AssociationThe Impact of Computerized Physician Order Entry on Medication Error Prevention
1,273 Citations1999D. W. Bates, Jonathan M. Teich +6 more
Computerized POE substantially decreased the rate of non-missed-dose medication errors, and a major reduction in errors was achieved with the initial version of the system, and further reductions were found with addition of decision support features.
Journal of the American Medical Informatics AssociationThe Impact of Electronic Health Records on Time Efficiency of Physicians and Nurses: A Systematic Review
909 Citations2005Lise Poissant
It is highlighted that a goal of decreased documentation time in an EHR project is not likely to be realized and how the selection of bedside or central station desktop EHRs may influence documentation time for the two main user groups, physicians and nurses is identified.
BMJUsing information technology to reduce rates of medication errors in hospitals
479 Citations2000David W. Bates
Although information technologies are widely used in hospitals, relatively few data are available regarding their impact on the safety of the process of giving drugs and other innovations, including using robots to fill prescriptions, bar coding, automated dispensing devices, and computerisation of the medication administration record should all eventually reduce error rates.
JAMAGuided Medication Dosing for Inpatients With Renal Insufficiency
450 Citations2001Glenn M. Chertow
Guided medication dosing for inpatients with renal insufficiency appears to result in improved dose and frequency choices, and demonstrates a way in which computer-based decision support systems can improve care.
BMJ Quality & SafetyWhat is a prescribing error?
419 Citations2000Bryony Dean, N Barber +1 more
A general definition of a prescribing error has been developed, which allows the comparison of prescribing error rates among different prescribing systems and different hospitals, and is suitable for use in both research and clinical governance initiatives.
BMJ Quality & SafetyPrescribing errors in hospital inpatients: their incidence and clinical significance
413 Citations2002Bryony Dean
Knowing where and when errors are most likely to occur will be helpful in designing initiatives to reduce them, and the methods developed could be used to evaluate such initiatives.
PEDIATRICSComputerized Physician Order Entry and Medication Errors in a Pediatric Critical Care Unit
409 Citations2004Amy Potts, Frances Barr +3 more
The implementation of CPOE resulted in almost a complete elimination of MPEs and RVs and a significant but less dramatic effect on potential ADEs.
Journal of the American Medical Informatics AssociationA Randomized Trial of "Corollary Orders" to Prevent Errors of Omission
380 Citations1997J. Marc Overhage, William M. Tierney +2 more
This study demonstrates that physician workstations, linked to a comprehensive electronic medical record, can be an efficient means for decreasing errors of omissions and improving adherence to practice guidelines.
BMJEthnographic study of incidence and severity of intravenous drug errors
376 Citations2003Katja Taxis, Nick Barber
The rate of intravenous drug errors was high and although most errors would cause only short term adverse effects, a few could have been serious and a combination of reducing the amount of preparation on the ward, training, and technology to administer slow bolus doses would probably have the greatest effect on error rates.
Optics LettersBuilding a safer NHS for patients: improving medication safety
284 Citations2004Jim Smith, Gillian Cavell
Relative intensity noise and frequency noise have been measured for the first time for a single-frequency Brillouin chalcogenide As38Se62 fiber laser.
Critical CareMedication errors: a prospective cohort study of hand-written and computerised physician order entry in the intensive care unit
251 Citations2005Rob Shulman, Mervyn Singer +2 more
Introduction of CPOE was associated with a reduction in the proportion of MEs and an improvement in the overall patient outcome score (if intercepted errors were included).
BMJImplementation of rules based computerised bedside prescribing and administration: intervention study
201 Citations2000Peter Nightingale
The computerised prescribing system assists clinicians when they are writing a prescription by making available information on patients and has been well received by doctors, nurses, and pharmacists.
Drug SafetyDrug-Related Problems in Hospitalised Patients
200 Citations2000Patricia M. L. A. van den Bemt, Toine C. G. Egberts +2 more
An overview of studies on drug-related problems in hospitalised patients, with specific attention to the incidence of drug- related problems and their costs, to the possibilities of prevention and to the effect of these interventions, is performed.
American Journal of Health-System PharmacyValidity and reliability of observational methods for studying medication administration errors
194 Citations2001Bryony Dean, Nick Barber
Concerns about the validity and reliability of observational methods for identifying MAEs may be unfounded, and observation of nurses during drug administration at a U.K. hospital did not significantly affect the MAE rate; nor did tactful interventions by the observers.
American Journal of Health-System PharmacyA validated, reliable method of scoring the severity of medication errors
191 Citations1999Bryony Dean, Nicholas Barber
A reliable, valid method of scoring the severity of medication errors that did not require knowledge of patient outcomes was developed; at least four judges were required in order to achieve reliable scores, and reliability was not affected by the professions of the judges or the number of occasions on which the errors were scored.
BMJ Quality & SafetyInformation technology and medication safety: what is the benefit?
159 Citations2002Rainu Kaushal
Computerized physician order entry with decision support significantly reduces serious inpatient medication error rates in adults and in outpatients, and computerization of prescribing and patient oriented approaches such as personalized web pages and delivery of web based information may be important.
American Journal of Health-System PharmacyComparison of medication errors in an American and a British hospital
146 Citations1995Bryony Dean, Elizabeth Louise Allan +2 more
An American hospital with a unit dose distribution system had a significantly higher medication error rate than a Britishhospital with a ward-based supply system.
Pharmacy World & ScienceHospital drug distribution systems in the UK and Germany--a study of medication errors.
107 Citations1999Katja Taxis, Bryony Dean +1 more
It was noted that patient turnover was much higher in the wards using the ward pharmacy system and therefore the study sites may not be comparable, and recommendations can be made in order to reduce the error rate associated with each system.
BMJ Quality & SafetyQualitative evaluation of an electronic prescribing and administration system
68 Citations2007Nick Barber, Tony Cornford +1 more
Electronic prescribing systems need to be seen as occasions for change and learning rather than as black-boxed technical solutions to identified problems.
OmegaExperience with a structure, process and outcome framework for evaluating an information system
61 Citations1994Tony Cornford, Gi Doukidis +1 more
The paper provides a framework to approach the evaluation task combining work in the area of information systems and health policy analysis, and is built around the three concepts of a system's structure, the process it supports and the outcome of its use.
BMJ Quality & SafetyMedication errors during hospital drug rounds.
61 Citations1995Keith Ridge, Duncan Jenkins +2 more
The observed rate of drug administration errors is too high and might be reduced by a multidisciplinary review of practices in prescribing, supply, and administration of drugs.
International Journal of Pharmacy PracticeWhen do medication administration errors happen to hospital inpatients?
41 Citations1997Catherine Ho, Bryony Dean +1 more
When medication administration errors are most likely to occur is determined by observing nurses preparing and administering medication on a care of the elderly ward during two eight‐day periods.
BMJ Quality & SafetyImproving prescribing using a rule based prescribing system
37 Citations2004Christopher G. Anton
Doctors are influenced by the experience of using a computerised prescribing system and when judged by the number of warning messages generated per prescription, their prescribing improves with time and number of prescriptions written.
Critical CareA comparison of handwritten and computer-assisted prescriptions in an intensive care unit
36 Citations1998Katya Evans, S. W. Benham +1 more
Computer-assisted prescriptions were more complete, signed and dated than handwritten prescriptions and was successfully integrated into clinical practice in the ICU.
International Journal of Pharmacy PracticeThe effects of a patients' own drugs scheme on the incidence and severity of medication administration errors
32 Citations2000Bryony Dean, Nick Barber
A large number of patients in the UK are using PODs schemes, in which patients' own medication is used during their stay, and it is suggested that these will reduce medication administration errors (MAEs), particularly those due to medication unavailability.
BMJ Quality & SafetyImproving prescribing using a rule based prescribing system
7 Citations2004Christopher G. Anton
University of Hertfordshire Research Archive (University of Hertfordshire)The effect of the controlled entry of electronic prescribing and medicines administration on the quality or prescribing, safety and success of administration on an acute medical ward
5 Citations2002Michael Almond, KJ Gordon +3 more
