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Electronic prescribing : Medication errors in ambulatory pediatrics
(Archived Project)
Investigator (PI): Johnson, Kevin B
Performing Organization (PO): (Current): Johns Hopkins Medicine, Johns Hopkins Children's Center, Department of Pediatrics
Supporting Agency (SA): Agency for Healthcare Research and Quality (AHRQ)
Initial Year: 2001
Final Year: 2006
Record Source/Award ID: CRISP/R18HS11868
Funding: Total Award Amount: $1,121,808
Award Type: Grant
Award Information: Reports resulting from this project
Abstract: The Institute of Medicine's report entitled "To Err is Human" identifies medication errors as an alarming and often preventable cause of patient morbidity and mortality. This report focused on the errors inherent in inpatient practice; however, advocates for child safety recognize the need for pediatric studies in this area. Children pose unique challenges, including increased risk incurred by weight-based dosing, and the potential for more serious consequences. The same challenges inherent in prescribing medications for children may pose difficulties for information systems designed to decrease medication errors. There are no studies examining the potential effects or problems associated with the use of tools for electronic prescribing in the pediatric population. This application proposes to assess the baseline medication error rate in an urban pediatric emergency department and clinic, staffed by attending physicians, fellows, and residents in all years of training. Implements of handheld electronic prescription writing will be compared and the effect that electronic prescribing has on medication error rates and prescribing practices will be determined. The first phase of this project will be an observational study. All patients being seen in the investigators' study sites for acute care who have a way of being contacted after filling their prescriptions will be eligible to be enrolled in this study. Each prescription will be logged, and patients will be contacted to compare the medication label with the original prescription. Any errors will be investigated by a data-monitoring team to determine the source of the error. The second phase of this project will be a randomized, controlled study using both paper-based and handheld electronic prescription writing tools in two pediatric outpatient facilities for two years. Each month, we will assign physicians to two-week blocks to utilize either paper-based or electronic prescribing. Randomization will change the method used by the site, rather than that used by the individual physician. The medication error rate will be determined in a fashion identical to that used during the first phase. At the end of each two-week block, all providers will complete a brief survey to quantify their compliance with recommended prescribing practices. These results will provide important data about the effectiveness of electronic prescription writing tools with respect to decreasing medication errors and improving prescribing practices. These results will be useful to commercial companies building tools to face the unique challenges of pediatrics. Finally, these results will help to guide additional studies about how information technology may improve pediatric patient care.
MeSH Terms:
  • * Drug Information Services
  • Drug Prescriptions /*statistics & numerical data
  • Emergency Service, Hospital
  • Humans
  • Internship and Residency
  • Medical Audit
  • * Medical Records Systems, Computerized
  • Medication Errors /*prevention & control
  • /statistics & numerical data
  • Microcomputers
  • Pediatrics /*statistics & numerical data
  • Personnel, Hospital
  • Physicians
  • Program Evaluation
  • Randomized Controlled Trials as Topic
  • Reference Values
  • United States
  • Urban Population
  • Writing
Keywords:
  • computer human interaction
  • health care personnel performance
  • health service demonstration project
  • human subject
  • medication error
  • outpatient care
  • pediatric pharmacology
  • pediatrics
  • personal computer
  • physician
  • research support, U.S. Gov't, P.H.S.
Country: United States
State: Maryland
Zip Code: 21287
UI: 20021424
Project Status: Archived
Record History: ('2002: Project title changed (Prior title: Impact of Electronic Prescribing on Medication Errors in Ambulatory Pediatrics.)',)