Giurdanella Pietro, Di Denia Patrizio
U.O. Chirurgia Generale, AO Policlinico S. Orsola Malpighi, Bologna.
Assist Inferm Ric. 2007 Apr-Jun;26(2):92-8.
Medication errors are the major responsible for adverse events in hospitals. Although computerized prescription systems are widely considered the best option to decrease the medication errors, this belief is not evidence based since only few studies assessed their effectiveness.
The aim of this study is to compare the effectiveness on reducing medication errors of the manual prescription system (drugs transcribed in the clinical records) with a computerized system.
Drugs prescriptions (manual and electronic) were retrospectively analyzed to identify medication errors. A medication error is the lack of clarity and completedness of the prescription.
1587 prescriptions were analyzed with the manual prescription system (phase 1), 1500 with the provisional electronic system (phase 2) and 1034 with the final one (phase 3). Between phase 1 and 2 an increase of incomplete prescriptions for dose (+17%) and lack of completedness of prescription (+49%) was observed. After some modifications a decrease of "errors" was observed, respectively -39% and -23.5% (p<0.001).
The study shows that the informatization of the drug prescriptions reduces medication errors but requires a close planning, monitoring and tailoring of the system according to local problems and needs.
用药错误是医院不良事件的主要原因。尽管计算机化处方系统被广泛认为是减少用药错误的最佳选择，但这种观点并非基于证据，因为仅有少数研究评估了其有效性。
本研究旨在比较手工处方系统（在临床记录中抄写药物）和计算机化系统在减少用药错误方面的有效性。
对药物处方（手工和电子）进行回顾性分析以识别用药错误。用药错误是指处方缺乏清晰度和完整性。
使用手工处方系统分析了1587张处方（第1阶段），使用临时电子系统分析了1500张（第2阶段），使用最终电子系统分析了1034张（第3阶段）。在第1阶段和第2阶段之间，观察到剂量不完整处方增加（+17%）以及处方完整性缺失增加（+49%）。经过一些修改后，“错误”出现减少，分别减少了39%和23.5%（p<0.001）。
该研究表明，药物处方信息化可减少用药错误，但需要根据当地问题和需求对系统进行周密规划、监测和调整。
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