Shemilt Katherine, Morecroft Charles W, Ford James L, Mackridge Adam J, Green Christopher
Centre for Pharmacy Innovation, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
Department of Pharmacy, Countess of Chester Hospital NHS Foundation Trust, Chester, UK.
Eur J Hosp Pharm. 2017 Jul;24(4):213-217. doi: 10.1136/ejhpharm-2016-000905. Epub 2016 Jun 30.
The individualised patient prescription chart, either paper or electronic, is an integral part of communication between healthcare professionals. The aim of this study is to ascertain the extent to which different prescribing systems are used for inpatient care in acute hospitals in England and explore chief pharmacists' opinions and experiences with respect to electronic prescribing and medicines administration (EPMA) systems.
Audio-recorded, semistructured telephone interviews with chief pharmacists or their nominated representatives of general acute hospital trusts across England.
Forty-five per cent (65/146) of the chief pharmacists agreed to participate. Eighteen per cent (12/65) of the participants interviewed stated that their trust had EPMA systems fully or partially implemented on inpatient wards. The most common EPMA system in place was JAC (n=5) followed by MEDITECH (n=3), iSOFT (n=2), PICS (n=1) and one in-house created system. Of the 12 trusts that had EPMA in place, 4 used EPMA on all of their inpatient wards and the remaining 8 had a mixture of paper and EPMA systems in use. Fifty six (86% 56/65) of all participants had consulted the standards for the design of inpatient prescription charts. From the 12 EPMA interviews qualitatively analysed, the regulation required to provide quality patient care is perceived by some to be enforceable with an EPMA system, but that this may affect accuracy and clinical workflow, leading to undocumented, unofficial workarounds that may be harmful.
The majority of inpatient prescribing in hospital continues to use paper-based systems; there was significant diversity in prescribing systems in use. EPMA systems have been implemented but many trusts have retained supplementary paper drug charts, for a variety of medications. Mandatory fields may be appropriate for core prescribing information, but the expansion of their use needs careful consideration.
个性化患者处方表，无论是纸质还是电子的，都是医疗保健专业人员之间沟通的重要组成部分。本研究的目的是确定在英格兰急性医院的住院护理中不同处方系统的使用程度，并探讨主任药师对电子处方和药品管理（EPMA）系统的意见和经验。
对英格兰各地综合急性医院信托的主任药师或其指定代表进行录音的半结构化电话访谈。
45%（65/146）的主任药师同意参与。18%（12/65）的受访参与者表示，他们所在的信托机构已在住院病房全面或部分实施了EPMA系统。最常用的EPMA系统是JAC（n=5），其次是MEDITECH（n=3）、iSOFT（n=2）、PICS（n=1）和一个内部创建的系统。在已实施EPMA的12个信托机构中，4个在其所有住院病房都使用了EPMA，其余8个同时使用纸质和EPMA系统。所有参与者中有56人（86%，56/65）参考了住院处方表设计标准。从对12次EPMA访谈进行的定性分析来看，一些人认为提供优质患者护理所需的规定可通过EPMA系统强制执行，但这可能会影响准确性和临床工作流程，导致未记录的、非官方的变通方法，可能会造成危害。
医院中大多数住院处方仍使用纸质系统；所使用的处方系统存在显著差异。EPMA系统已得到实施，但许多信托机构仍保留了用于各种药物的补充纸质药品图表。强制字段可能适用于核心处方信息，但其使用范围的扩大需要仔细考虑。
