Electronic Prescribing--Medication Errors in Pediatrics

描述：申请人逐字摘录？S摘要 中国医学研究院S题为《犯错是人》的报告指出 用药差错是一种令人担忧的、往往可以预防的患者原因 发病率和死亡率。这份报告主要关注的是 住院实践；然而，儿童安全倡导者认识到有必要 这方面的儿科研究。儿童构成独特的挑战，包括 基于体重的剂量会增加风险，并有可能出现更多 严重的后果。开药所固有的同样挑战 对于儿童来说，可能会给旨在减少 用药失误。目前还没有研究检验潜在的影响或 与使用电子处方工具有关的问题 儿科人口。 此应用程序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、研究员和住院医生接受过所有年的培训。实施的工具 手持式电子处方书写将会比较和效果 电子处方对用药错误率和处方做法有影响 将会被确定。 该项目的第一阶段将是一项观察性研究。所有患者 在调查员身上被看到了？急性护理研究网站，他们有办法 在填写处方后被联系将有资格 参加了这项研究。每一张处方都将被记录下来，患者将 联系以将用药标签与原始处方进行比较。 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。这个项目的第二阶段将是一个随机的， 纸质和手持电子处方对照研究 在两个儿科门诊机构工作了两年。每个人 月，我们将分配医生进行为期两周的分组，以使用基于纸张的 或者电子处方。随机化将改变 网站，而不是个别医生使用的网站。药物治疗 确定错误率的方式将与在 第一阶段。在每个为期两周的课程结束时，所有的提供者都将完成一份 为量化他们对推荐处方的遵从性而进行的简短调查 练习。 这些结果将提供有关联合治疗有效性的重要数据。 与减少用药有关的电子处方书写工具 错误和改进处方做法。这些结果将有助于 商业公司正在开发工具，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.