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Interventions to reduce medication prescribing errors in a paediatric cardiac intensive care unit.

Abstract：

OBJECTIVE:To identify and reduce medication-prescribing errors by introducing systematic physician education and post-cardiac surgery admission prescription forms. DESIGN:Errors were defined as: incomplete prescriptions; potential adverse drug events (ADEs), i.e. either intercepted or non-intercepted incorrect prescriptions not resulting in an ADE; and incorrect prescriptions that resulted in ADEs. Two baseline blinded pre-intervention data collection periods of 4 weeks and 1 week were followed by implementation of a post-cardiac surgery templated physician order and prescription form and systematic physicians' education. Twelve post-intervention data collections of 1-week duration were completed over a 3-year period and were either blinded or informed with reinforcement of physicians' education. SETTING:Tertiary paediatric cardiac intensive care unit. RESULTS:A total of 3648 prescriptions were evaluated at baseline (mean +/- SD of 687+/- 8 per week) and 811 +/- 129 prescriptions during each post-intervention period. Total baseline errors of 16.8% decreased to 8.4% after the first blinded data collection and to 4.8% at the final data collection (p<0.001). The occurrence of incomplete prescriptions fell from 15.3% at baseline to 3.6% at final data collection (p<0.001); intercepted potential ADEs fell from 1.3% to 1.1%; non-intercepted potential ADEs fell from 0.17% to zero; and post-operative prescribing errors fell from 44% to 4.6% (p<0.001), with the major reduction seen in incomplete prescriptions. CONCLUSION:The incidence of incomplete prescriptions significantly improved with education of physicians and use of post-cardiac surgery templated physician order and prescription forms. There was no impact on potential ADEs.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Burmester MK,Dionne R,Thiagarajan RR,Laussen PC

doi

10.1007/s00134-008-1054-3

subject

Has Abstract

pub_date

2008-06-01 00:00:00

pages

1083-90

issue

6

eissn

0342-4642

issn

1432-1238

journal_volume

34

pub_type

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