Whitaker Megan, Lester Corey, Rowell Brigid
From the School of Information & School of Public Health, University of Michigan, Ann Arbor, Michigan.
College of Pharmacy, University of Michigan, Ann Arbor, Michigan.
J Patient Saf. 2024 Sep 1;20(6):397-403. doi: 10.1097/PTS.0000000000001244. Epub 2024 May 15.
The aims of the study are to understand the process of how community pharmacies handle electronic prescriptions (e-prescriptions) and learn about different errors or potential errors encountered.
Fifteen remote, semistructured interviews were conducted with community pharmacy staff. Interview analysis was done with two adapted Systems Engineering Initiative for Patient Safety methods to understand the workflow and an affinity wall, which led to key words that were tallied to understand the frequency of different issues.
Data entry in community pharmacies is a process that varies based on the different software platforms receiving e-prescriptions. Data entry of a medication product is typically a human-reliant process matching an e-prescription with an equivalent medication product. Current automated safety supports focus on matching the dispensed medication to the medication chosen at data entry. Substitutions may be required for a variety of reasons, however, pharmacists' comfort and permissions in doing so without provider involvement fluctuates.
Prescription errors remain that could be prevented with additional support at the data entry step of e-prescriptions. Few studies demonstrate where these errors originate and what role current technology plays in contributing to or preventing these errors. Future work must consider how these matches between prescribed medications and pharmacy fulfilled medications occur. There is a need to identify potential tools to support data entry and prevent medication errors.
本研究旨在了解社区药房处理电子处方的过程,并了解所遇到的不同错误或潜在错误。
对社区药房工作人员进行了15次远程半结构化访谈。采用两种经改编的患者安全系统工程倡议方法进行访谈分析,以了解工作流程,并使用亲和墙,从而得出关键词,统计关键词以了解不同问题的出现频率。
社区药房的数据录入过程因接收电子处方的软件平台不同而有所差异。药品的数据录入通常是一个依赖人工的过程,即将电子处方与等效药品进行匹配。当前的自动化安全支持侧重于将配发的药品与数据录入时所选的药品进行匹配。然而,由于各种原因可能需要进行替代,药师在无需医生参与的情况下进行替代时的舒适度和权限各不相同。
在电子处方的数据录入步骤中,若能提供更多支持,仍可预防处方错误。很少有研究表明这些错误源自何处,以及当前技术在导致或预防这些错误中所起的作用。未来的工作必须考虑处方药品与药房配发药品之间的这些匹配是如何发生的。有必要确定支持数据录入并预防用药错误的潜在工具。