Chemotherapy prescribing errors: an observational study on the role of information technology and computerized physician order entry systems

BMC Health Services Research

Gianpiero Fasola⁵  Loris Zanier¹  Angela Denaro²  Lorena Gurrieri⁵  Federica De Pauli⁵  Laura Deroma³  Elisa De Carlo⁵  Ornella Belvedere⁴  Marianna Aita⁵ 

[1] Health Directorate, Friuli Venezia-Giulia Region, Trieste, Italy;Department of Medical Oncology, University Hospital of Trieste, Trieste, Italy;Regional Coordinator Centre for Rare Diseases, University Hospital of Udine, Udine, Italy;Department of Oncology, York Teaching Hospital, York, UK;Department of Oncology, S. Maria della Misericordia, University Hospital, Udine, Italy

关键词: Outpatient;    Prescribing errors;    Information technology;    Computerized physician order entry (CPOE) systems;    Chemotherapy;    Adverse drug event;   

Others  :  1134442
DOI  :  10.1186/1472-6963-13-522

 received in 2013-10-07, accepted in 2013-12-11,  发布年份 2013

【 摘 要 】

Background

Chemotherapy administration is a high-risk process. Aim of this study was to evaluate the frequency, type, preventability, as well as potential and actual severity of outpatient chemotherapy prescribing errors in an Oncology Department where electronic prescribing is used.

Methods

Up to three electronic prescriptions per patient record were selected from the clinical records of consecutive patients who received cytotoxic chemotherapy between January 2007 and December 2008. Wrong prescriptions were classified as incomplete, incorrect or inappropriate. Error preventability was classified using a four-point scale. Severity was defined according to the Healthcare Failure Mode and Effect Analysis Severity Scale.

Results

Eight hundred and thirty-five prescriptions were eligible. The overall error rate was 20%. Excluding systematic errors (i.e. errors due to an initially faulty implementation of chemotherapy protocols into computerized dictionaries) from the analysis, the error rate decreased to 8%. Incomplete prescriptions were the majority. Most errors were deemed definitely preventable. According to error presumptive potential for damage, 72% were classified as minor; only 3% had the potential to produce major or catastrophic injury. Sixty-eight percent were classified as near misses; adverse drug events had no or little effect on clinical outcome.

Conclusions

Chemotherapy prescribing errors may arise even using electronic prescribing. Although periodic audits may be useful to detect common errors and guide corrective actions, it is crucial to get the computerized physician order entry system and set-ups correct before implementation.

【 授权许可】

   
2013 Aita et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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