Document Detail


Computerized physician order entry of injectable antineoplastic drugs: an epidemiologic study of prescribing medication errors.
MedLine Citation:
PMID:  20829102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In the context of CPOE of standardized antineoplastic drugs, the objectives of the present study were to determine the incidence of prescribing medication errors (PME) and to analyse PME related to antineoplastic treatment in university teaching hospitals.
METHODS: All consecutive prescribing medication orders over 1 year were analysed prospectively. Potential clinical impact was quoted according to the Hatoum scale and risk factors identified with a logistic-regression model.
RESULTS: A total of 14,854 prescriptions were analysed. The PME incidence was estimated at 1.5% [1.3-1.7], i.e. 15 errors per 1000 prescribing medication orders, with a significant or very significant potential clinical impact in 62.9% of cases. Potentially death-threatening events were avoided in 3.7% of cases. Overall, PME incidence related to significant, very significant or vital potential clinical impact was estimated to be 1.0% [0.8-1.2], i.e. 10 errors per 1000 prescribing medication orders. The most common type of error was related to antineoplastic drug dosage (61.0%): inadequate adaptation (43.1%), not taking alarms into account (16.1%), incorrect weight (0.9%), incorrect unit (0.9%). More than 20% of PME are medication errors directly linked to the prescribing medication order (choice of antineoplastic treatment, double-prescribing medication order, forgotten or not validated by a resident or senior physician). Occasional users of the CPOE system and resident physicians were identified as main PME risk factors.
CONCLUSION: An epidemiologic survey of PME in the context of the use of a partial CPOE has allowed to determine the incidence and epidemiology of PME as well as the potential clinical impact they represent. Two risk factors have emerged that can be considered from an organization and software points of view. Better pharmacist's analysis of prescribing medication order within the CPOE system could possibly minimize duplication of antineoplasic drugs and the vital clinical impact associated with overdosage.
Authors:
V Nerich; S Limat; M Demarchi; C Borg; P S Rohrlich; E Deconinck; V Westeel; C Villanueva; M C Woronoff-Lemsi; X Pivot
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of medical informatics     Volume:  79     ISSN:  1872-8243     ISO Abbreviation:  Int J Med Inform     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9711057     Medline TA:  Int J Med Inform     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  699-706     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Pharmacy, Jean Minjoz University Teaching Hospital, Besançon, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / administration & dosage*
Female
Humans
Injections, Intravenous
Male
Medical Order Entry Systems*
Medication Errors / statistics & numerical data*
Middle Aged
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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