Electronic Prescribing--Medication Errors in Pediatrics

描述：申请人的逐字记录？的抽象 医学研究所？题为《人皆有错》的报告指出， 用药错误是一个令人担忧的，往往是可以预防的原因， 发病率和死亡率。这份报告集中讨论了 住院实践;然而，儿童安全的倡导者认识到需要 儿科研究在这方面。儿童构成独特的挑战，包括 基于体重的剂量增加了风险， 严重后果开处方药所固有的挑战 可能会给旨在减少儿童死亡的信息系统带来困难。 用药错误。没有研究检查潜在的影响或 与使用电子处方工具有关的问题， 儿科人群。 本申请建议评估基线用药错误率， 城市儿科急诊科和诊所，配备主治医生 医生、研究员和住院医生在所有年份的培训。器具 手持电子处方书写将进行比较， 电子处方对用药错误率和处方实践的影响 将被确定。 该项目的第一阶段将是一项观察性研究。所有患者 在调查人员中被发现？研究中心的急性护理谁有一种方法， 在填写他们的处方后被联系的人将有资格 参加了这项研究。每个处方都将被记录，患者将 联系，以比较药物标签与原始处方。 任何错误都将由数据监控团队进行调查，以确定 错误的来源。该项目的第二阶段将是一个随机， 使用纸质和手持电子处方的对照研究 在两个儿科门诊机构使用书写工具两年。每个 一个月，我们将分配医生两个星期的块，利用基于纸张 或电子处方。随机化将改变 网站，而不是由个别医生使用。药物 错误率将以与在 第一阶段。在每个两周的块结束时，所有提供者将完成一个 简要调查，以量化他们对推荐处方的依从性 实践 这些结果将提供有关有效性的重要数据， 关于减少药物的电子处方书写工具 错误和改进处方实践。这些结果将有助于 商业公司构建工具，以应对 儿科.最后，这些结果将有助于指导更多的研究 关于信息技术如何改善儿科病人的护理。

DESCRIPTION: Verbatim from the Applicant?s 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 difficulty 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.