Huertas Fernández María J, Baena-Cañada José M, Martínez Bautista María J, Arriola Arellano Esperanza, García Palacios María Victoria
Pharmacy Clinical Management Unit. Puerta del Mar University Hospital. Cádiz. Spain.
Clin Transl Oncol. 2006 Nov;8(11):821-5. doi: 10.1007/s12094-006-0138-1.
The authors sought to evaluate the impact of computerised chemotherapy prescription on the reduction of medication errors. The purpose of this study was to assess the incidence of errors present in electronic versus manual prescription.
The data gathered from computerised chemotherapy prescription sheets were submitted to a prospective analysis as cases of the intervention groups. The control group was comprised of the handwritten chemotherapy prescription sheets. Chemotherapy prescriptions for consecutive oncology patients were analysed by 2 independent examiners, who investigated errors of omission, commission, interpretation of dates, abbreviations and illegible handwriting. The proportion of treatment prescriptions containing one or more errors and the median of errors were calculated in order in both groups.
At least one error was detected in 100% of the manual prescriptions and in 13% of computerised prescriptions (p < 0.001). The median of errors per computerised prescription was 0 (range: 0- 1), whereas in manual prescriptions the median was 5 (range: 1-12) (p < 0.001). Errors of omission were predominant in manual prescriptions. Errors of commission were limited to 1 case of unjustified cytostatic agent infra-dosage in a computerised prescription. This error was present in 3 cases in handwritten prescriptions and, in addition, 1 case of premedication drug substitution was detected. Errors of interpretation of the date, use of abbreviations and illegible handwriting were frequent among manual prescriptions and were absent from computerised prescriptions.
Electronic chemotherapy prescription is a powerful tool. In this study it has been shown to decrease chemotherapy-related medication errors and ensure that safe chemotherapy practices were followed.
作者试图评估计算机化化疗处方对减少用药错误的影响。本研究的目的是评估电子处方与手写处方中错误的发生率。
从计算机化化疗处方单收集的数据作为干预组病例进行前瞻性分析。对照组由手写化疗处方单组成。两名独立审查员分析连续肿瘤患者的化疗处方，调查遗漏、失误、日期解读、缩写和字迹模糊等错误。计算两组中包含一个或多个错误的治疗处方比例以及错误中位数。
在100%的手写处方和13%的计算机化处方中检测到至少一个错误（p<0.001）。每张计算机化处方的错误中位数为0（范围：0 - 1），而手写处方的中位数为5（范围：1 - 12）（p<0.001）。手写处方中遗漏错误占主导。失误错误仅限于计算机化处方中有1例细胞抑制剂剂量不足的不合理情况。此错误在手写处方中有3例，此外，还检测到1例预处理药物替换情况。日期解读错误、缩写使用错误和字迹模糊在手写处方中很常见，在计算机化处方中不存在。
电子化疗处方是一种有力工具。本研究表明它可减少化疗相关用药错误，并确保遵循安全的化疗操作规范。
