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The Effect of Computer‐assisted Prescription Writing on Emergency Department Prescription Errors
Author(s) -
Bizovi Kenneth E.,
Beckley Brandon E.,
McDade Michelle C.,
Adams Annette L.,
Lowe Robert A.,
Zechnich Andrew D.,
Hedges Jerris R.
Publication year - 2002
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1197/aemj.9.11.1168
Subject(s) - medical prescription , medicine , emergency department , confidence interval , pharmacist , odds ratio , formulary , emergency medicine , medical emergency , family medicine , pharmacy , nursing
Objective: To determine whether computer‐assisted prescription writing reduces the frequency of prescription errors in the emergency department (ED). Methods: A pre—post retrospective analysis was used to compare errors between handwritten (HW) and computer‐assisted (CA) ED prescriptions. Prescriptions were reviewed for pharmacist clarifications. A clarification was defined as an error if missing information, incorrect information, incorrect dose, non‐formulary medication, or illegibility was the reason for clarification. The HW and CA error rates were compared using odds ratios (ORs) with 95% confidence intervals (95% CIs). Results: During the pre‐intervention period, there were 7,036 patient visits with 2,326 HW ED prescriptions filled for 1,459 patients. There were 91 clarifications, with a rate of 3.9%. There were 54 HW errors, for an error rate of 2.3%. During the post‐intervention period, there were 7,845 patient visits with 1,594 CA prescriptions filled for 1,056 patients. There were 13 clarifications, with a clarification rate of 0.8%, and 11 errors, for a CA error rate of 0.7%. The CA prescriptions were substantially less likely to contain an error [OR 0.31 (95% CI = 0.10 to 0.36)] or to require pharmacist clarification [OR 0.19 (95% CI = 0.10 to 0.36)] than were the HW prescriptions. Conclusions: Computer‐assisted prescriptions were more than three times less likely to contain errors and five times less likely to require pharmacist clarification than handwritten prescriptions.