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57 Exploring the functions of an E-prescribing system to reduce prescribing errors and improve inpatient medication record keeping
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  1. Nicholas Keyi Sim,
  2. Talia Walter,
  3. Sally Pickin,
  4. Sophie Stanger,
  5. Eleanor Tanqueray,
  6. Justin Sperrin,
  7. Nadisha Subramaniam,
  8. Sophie Mullins,
  9. Polly Rusby,
  10. Giles Atton,
  11. Thomas Isaac,
  12. David Royan,
  13. Steve Ramcharita
  1. *Great Western Hospitals NHS Foundation Trust, UK

Abstract

The e-prescribing system at the Great Western Hospital offers a note taking system that pharmacy uses to record a 24-hour drug history and allows users to add notes clarifying any changes.

A QI project aimed to reduce near-misses caused by prescribing errors by increasing the utilisation of the 24-hour drug history and note system. This was done via education targeted at the primary users of the system using pre-existing channels in the trust. Three cycles of interventions were implemented: teaching the prescribers how to use the system during teaching sessions, increasing publicity via posters in clinical areas and trust mailing lists, and making a version of the guide available on the trust intranet.

The primary measure was the number of near-misses identified from pharmacy phone calls to the medical team in a 24-hour period, which fell from 22 to 10 to 8 to 7. Secondary measures were the percentage drug histories being ‘read’, which improved from 12.77% to 23.26% initially but fell to 2.38% and 4.65%; and the percentages of drug charts with notes clarifying discrepancies which changed little despite intervention from 18.92% to 28.00% to 33.33% to 29.54%.

The interventions show that it is possible to use existing trust education channels to produce a sustainable reduction in near-misses. The reduction in percentage drug histories being ‘read’, and the lack of change in the percentages of drug charts with notes clarifying discrepancies illustrate the challenges in using an e-prescribing system.

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