Influence of a Systems-Based Approach to Prescribing Errors in a Pediatric Resident Clinic.

OBJECTIVE: To measure the difference in prescribing error rates between 2 clinics, 1 with a system in place to reduce errors and 1 with no such system; to determine variables that affect the likelihood of prescription errors. METHODS: This was a retrospective study at 2 university-based general pedi...

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Published in:Academic Pediatrics Vol. 14; no. 5; pp. 485 - 491
Main Authors: Condren, Michelle, Honey, Brooke L., Carter, Sandra M., Ngo, Nelson, Landsaw, Jeremy, Bryant, Cheryl, Gillaspy, Stephen
Format: research tables/charts Journal Article
Published: Elsevier B.V. Sep/Oct2014
Online Access:View this record in EBSCOhost
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      dt: Sep/Oct2014
      vid: 14
      iid: 5
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      pub: Elsevier B.V.
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        10.1016/j.acap.2014.03.018
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        atl: Influence of a Systems-Based Approach to Prescribing Errors in a Pediatric Resident Clinic.
      aug:
        au:
          Condren, Michelle
          Honey, Brooke L.
          Carter, Sandra M.
          Ngo, Nelson
          Landsaw, Jeremy
          Bryant, Cheryl
          Gillaspy, Stephen
        affil: Department of Pharmacy, Clinical and Administrative Sciences—Tulsa, University of Oklahoma College of Pharmacy; Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, Okla
      sug:
        subj:
          Pediatric Care
          Prescribing Patterns
          Medication Errors
          Human
          Systems Analysis
          Oklahoma
          Academic Medical Centers
          Electronic Health Records
          Retrospective Design
          Multicenter Studies
          Comparative Studies
          Data Analysis Software
          T-Tests
          Linear Regression
          Chi Square Test
          Logistic Regression
          Infant
          Child, Preschool
          Child
          Adolescence
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
      ab: OBJECTIVE: To measure the difference in prescribing error rates between 2 clinics, 1 with a system in place to reduce errors and 1 with no such system; to determine variables that affect the likelihood of prescription errors. METHODS: This was a retrospective study at 2 university-based general pediatric clinics utilizing the same electronic medical record (EMR) system. Clinic 1 employed pharmacists who provided daily prescription review, provider feedback and education, and EMR customization to decrease errors. Clinic 2 had no systems in place for reducing prescribing errors. Prescriptions written by resident physicians over 2 months were identified and reviewed. RESULTS: a total of 1361 prescriptions were reviewed, 40.7% from clinic 1 and 59.3% from clinic 2. Errors were found in 201 prescriptions (14.8%). Clinics 1 and 2 had error rates of 11% and 17.5%, respectively (P = .0012). The odds of a prescription error at clinic 2 were 1.7 times the odds of a prescription error at clinic 1. Logistic regression identified clinic, nonpediatric resident, liquid dose forms, and younger patient age as significant predictors of prescription errors. Half of the errors could have been prevented with consistent use of a custom medication list within the EMR. CONCLUSIONS: We found 37% fewer prescribing errors in a clinic with systems in place for prescribing error detection and prevention. Pediatric clinics should explore systematic procedures for identifying, resolving, and providing education about prescribing errors to reduce patient risk.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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