Abstract
OBJECTIVE: To investigate the changes in overdue doses rates over a 4-year period in an National Health Service (NHS) teaching hospital, following the implementation of interventions associated with an electronic prescribing system used within the hospital.
DESIGN: Retrospective time-series analysis of weekly dose administration data.
SETTING: University teaching hospital using a locally developed electronic prescribing and administration system (Prescribing, Information and Communication System or PICS) with an audit database containing details on every drug prescription and dose administration.
PARTICIPANTS: Prescription data extracted from the PICS database.
INTERVENTION(S): Four interventions were implemented in the Trust: (i) the ability for doctors to pause medication doses; (ii) clinical dashboards; (iii) visual indicators for overdue doses and (iv) overdue doses Root Cause
ANALYSIS: (RCA) meetings and a National Patient Safety Agency (NPSA) Rapid Response Alert. Main outcome measure(s) The percentage of missed medication doses.
RESULTS: Rates of both missed antibiotic and non-antibiotic doses decreased significantly upon the introduction of clinical dashboards (reductions of 0.60 and 0.41 percentage points, respectively), as well as following the instigation of executive-led overdue doses RCA meetings (reductions of 0.83 and 0.97 percentage points, respectively) and the publication of an associated NPSA Rapid Response Alert. Implementing a visual indicator for overdue doses was not associated with significant decreases in the rates of missed antibiotic or non-antibiotic doses.
CONCLUSIONS: Electronic prescribing systems can facilitate data collection relating to missed medication doses.
INTERVENTIONS: providing hospital staff with information about overdue doses at a ward level can help promote reductions in overdue doses rates.
Original language | English |
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Pages (from-to) | 564-72 |
Number of pages | 9 |
Journal | International Journal for Quality in Health Care |
Volume | 25 |
Issue number | 5 |
DOIs | |
Publication status | Published - Oct 2013 |
Keywords
- Anti-Bacterial Agents
- Hospitals, Teaching
- Humans
- Medical Order Entry Systems
- Medication Errors
- Medication Systems, Hospital
- Quality Improvement
- Retrospective Studies
- Journal Article
- Research Support, Non-U.S. Gov't