Caruso Michelle C, Gittelman Michael A, Widecan Michelle L, Luria Joseph W
From the *Division of Pharmacy and †Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Emerg Care. 2015 Jun;31(6):403-8. doi: 10.1097/PEC.0000000000000457.
The aims of the study were to analyze and classify reasons why retail pharmacies need to contact the pediatric emergency department (PED) for clarification on outpatient prescriptions generated using an electronic prescribing system and to categorize the severity of errors captured.
A retrospective chart review was conducted at a PED that cares for approximately 92,000 patients annually. All pharmacy callbacks documented in the electronic medical record between August 1, 2008 and July 31, 2009 were included. A datasheet was used to capture patient demographics (age, sex, race, insurance), prescriptions written, and reason for callback. Each call was then assigned a severity level, and time to respond to all calls was estimated. Frequencies were used to analyze the data.
A total of 731 errors for 695 callbacks were analyzed from 49,583 prescriptions written at discharge. The most common errors included administrative/insurance issues 342/731 (47%) and prescription writing errors 298/731 (41%). The errors were classified as insignificant (340/729 [47%]), problematic (288/729 [40%]), significant (77/729 [11%]), serious (12/729 [1.64%]), and severe (12/729 [1.64%]). Almost 96% of errant prescriptions were not able to be filled as originally written and required a change by the prescriber. These calls required approximately 127 hours to complete.
Prescription errors requiring a pharmacy callback are typically insignificant. However, 13.8% of callbacks about an error were considered significant, serious, or severe. Automated dose checking and verifying insurance coverage of prescribed medications should be considered essential components of prescription writing in a PED.
本研究旨在分析并分类零售药店就使用电子处方系统开具的门诊处方联系儿科急诊科（PED）以寻求澄清的原因，并对所发现错误的严重程度进行分类。
在一家每年接诊约92,000名患者的儿科急诊科进行回顾性病历审查。纳入2008年8月1日至2009年7月31日期间电子病历中记录的所有药房回电。使用数据表记录患者人口统计学信息（年龄、性别、种族、保险）、开具的处方以及回电原因。然后为每个回电指定一个严重程度级别，并估计回复所有回电所需的时间。采用频率分析数据。
从出院时开具的49,583份处方中分析了695次回电中的731个错误。最常见的错误包括行政/保险问题342/731（47%）和处方书写错误298/731（41%）。这些错误被分类为无意义（340/729 [47%]）、有问题（288/729 [40%]）、重大（77/729 [11%]）、严重（12/729 [1.64%]）和极严重（12/729 [1.64%]）。几乎96%的错误处方无法按原书写内容配药，需要开处方者进行更改。这些回电大约需要127小时才能完成。
需要药房回电的处方错误通常无意义。然而，13.8%的关于错误的回电被认为是重大、严重或极严重的。自动剂量检查和核实所开药物的保险覆盖范围应被视为儿科急诊科处方书写的重要组成部分。
