Electronic prescribing reduced prescribing errors in a pediatric renal outpatient clinic

Abstract

Objective: To assess the effect of an electronic prescribing (EP) system on the incidence and type of prescribing errors and the number of error-free visits.

Study design: This was a before-and-after study conducted in a nephrology outpatient clinic at an acute tertiary care pediatric hospital.

Results: A total of 520 patients had 2242 items prescribed on 1141 prescriptions during the study period. The overall prescribing error rate was 77.4% (95% confidence interval [CI] = 75.3% to 79.4%) for handwritten items and 4.8% (95% CI = 3.4% to 6.7%) with EP. Before EP, 1153 (73.3%; 95% CI = 71.1% to 75.4%) items were missing essential information, and 194 (12.3%; 95% CI = 10.8% to 14%) were judged illegible. After EP, only 9 (1.4%; 95% CI = 0.7% to 2.6%) items were missing essential information, and illegibility errors were eliminated. The number of patient visits that were error-free increased from 21% to 90% (69% difference; 95% CI = 64% to 73.4%) after the implementation of EP.

Conclusions: There was a high incidence of errors using handwritten prescriptions in the outpatient setting, with an overall error rate of 77.4%. EP significantly reduced errors related to completeness of prescriptions and eliminated legibility related errors.