Impact of computerised chemotherapy prescriptions on the prevention of medication errors
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The authors sought to evaluate the impact of computerised chemotherapy prescription on the reduction of medication errors. The purpose of this study was to assess the incidence of errors present in electronic versus manual prescription.
Material and methods
The data gathered from computerised chemotherapy prescription sheets were submitted to a prospective analysis as cases of the intervention groups. The control group was comprised of the handwritten chemotherapy prescription sheets. Chemotherapy prescriptions for consecutive oncology patients were analysed by 2 independent examiners, who investigated errors of omission, commission, interpretation of dates, abbreviations and illegible handwriting. The proportion of treatment prescriptions containing one or more errors and the median of errors were calculated in order in both groups.
At least one error was detected in 100% of the manual prescriptions and in 13% of computerised prescriptions (p<0.001). The median of errors per computerised prescription was 0 (range: 0–1), whereas in manual prescriptions the median was 5 (range: 1–12) (p<0.001). Errors of omission were predominant in manual prescriptions. Errors of commission were limited to 1 case of unjustified cytostatic agent infra-dosage in a computerised prescription. This error was prescnt in 3 cases in hand-written prescriptions and, in addition, 1 case of premedication drug substitution was detected. Errors of interpretation of the date, use of abbreviations and illegible handwriting were frequent among manual prescriptions and were absent from computerised prescriptions.
Electronic chemotherapy prescription is a powerful tool. In this study it has been shown to decrease chemotherapy-related medication errors and ensure that safe chemotherapy practices were followed.
- National Coordinating Council for Medication Error Reporting and Prevention. NCCMERP Taxonomy of medication errors, 1998. [consulted on 15-11-2005]: Available at: http://www.nccmerp.org/abo utmederrors.htm.
- Brennan TA, Leape LI, Laird NM, et al. Incidence of adverse events and negligene in hospitalized patients: results from the Harvard Medical Practice Study I. N Engl J Med. 1991;324:370–6. CrossRef
- Allan EL, Barker KN. Fundamentals of medication errors research. Am J Hosp Pharm. 1990;47:555–71.
- Bates DW, Boyle DL, Vander Vliet MB, Schneider J, Leape LL. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995;10:199–205. CrossRef
- Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA. 1995;274(1):29–34. CrossRef
- Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalised patients. JAMA. 1997;227:307–11. CrossRef
- Sánchez E, Fernández LC, Giménez J, Fernández N, Marín I, Ynfante JI. Evaluacíon de errors en prescriptiones antineoplásicas. Seguim Farmacoter. 2003;1(3):105–9.
- Anonymous. Criteria for facilities and personnel for the administration of parenteral systemic antineoplastic therapy. J Clin Oncol. 2004:22(22):4613–5.
- Anonymous. American Society of Clinical Oncology statement regarding the use of outside services to prepare or administer chemotherapy drugs. J Clin Oncol. 2003; 21(9):1882–3.
- Bates DW, Leape LL, Cullen DJ, et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA. 1998;280:1311–6. CrossRef
- Bates DW, Teich JM, Lee J, et al. The impact of computerized physician order entry on medication error prevention. JAMA. 1999;6:313–21.
- Raschke RA, Gollihare B, Wunderlich TA, et al. A computer alert system to prevent injury from adverse drug events. Development and evaluation in a community teaching hospital. JAMA. 1998;280:1317–20. CrossRef
- Bobb A, Gleason K, Husch M, Feinglass J, Yarnold PR, Noskin GA. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Arch Intern Med. 2004;164(7):785–92. CrossRef
- Grupo Español para el Desarrollo de la Farmacia Oncológica (GEDEFO). Documento de consenso para la prevención de errores de medicación en quimioterapia, 2001. [consulted on 20-11-2005]: Available at: http://www.cancer.amgen.es
- Bates DW, Cohen M, Leape LJ, Overhage M, Shabot MM, Sheridan T. Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc. 2001;8(4):299–308.
- Kaushal R, Shojania KG, Bates DW. Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review. Arch Inter Med. 2003;163(12):1409–16. CrossRef
- Aguirrezábal A, Álvarez M, Yurrebaso MJ, et al. Detección de errores en la prescripción de quimioterapia. Farm Hosp. 2003;27(4):219–23.
- Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348(25):2526–34. CrossRef
- Gouveia WA, Shane R, Clark T. Computerized prescriber order entry: power, not panacea. Am J Health Syst Pharm. 2003; 60:1838.
- Lesar TS, Briceland L, Stein DS. Factors related to errors in medication prescribing. JAMA. 1997;277(4):312–7. CrossRef
- American Society of Hospital Pharmacists. ASHP guidelines on preventing medication errors in hospitals. Am J Health-Syst Pharm. 2002;59:1648–88.
- Schulmeister L. Chemotherapy medication errors: descriptions, severity, and contributing factors. Oncol Nurs Forum. 1999;26(6):1033–42.
- Goyache Goñi MP, Vicario Zubizarreta MJ, Garcia Rodríguez MP, Cortijo Cascajares S, Esteban Gómez MJ, Herreros de Tejada A. Errores de prescripción en citostáticos: análisis de sus causas y propuestas para evitarlos. Farm Hosp. 2004;28(5):361–70.
- Schulmeister L. Ten simple strategies to prevent chemotherapy errors. Clin J Oncol Nurs. 2005;9(2):201–5. CrossRef
- Aranaz JM, Aibar C, Gea MT, León MT. Efectos adversos en la asistencia hospitalaria. Una revisión crítica. Med Clin. 2004;123(1):21–5. CrossRef
- Aranaz JM. Sucesos adversos relacionados con el uso de medicamentos: équé podemos aprender? Med Clin. 2006;125 (5):97–8.
- Koppel R, Metlay JP, Cohen A, et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293(10):1197–203. CrossRef
- Impact of computerised chemotherapy prescriptions on the prevention of medication errors
Clinical and Translational Oncology
Volume 8, Issue 11 , pp 821-825
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- medication error
- electronic prescription
- manual/handwritten prescription
- computerised physician order entry
- Industry Sectors
- Author Affiliations
- 1. Pharmacy Clinical Management Unit, Puerta del Mar University Hospital, Cádiz, Spain
- 3. Mammary Pathology Clinical Management Unit, Puerta del Mar University Hospital, Cádiz, Spain
- 4. Medical Oncology Department, Puerta del Mar University Hospital, Cádiz, Spain
- 5. Preventive Medicine Department, Puerta del Mar University Hospital, Cádiz, Spain