Authors (including presenting author) :
Sin CMH(1), Lo CCH(1)
Affiliation :
(1) Pharmacy Department, United Christian Hospital
Introduction :
Recent data have shown that the implementation of IPMOE has significantly reduced prescribing errors in adults; however, reports have not paid particular attention to its benefits to targeted populations such as children, which has medication error risks entity of its own. Indeed, the adoption of electronic paediatric prescribing has been strongly endorsed by studies as medication error rates were found to be higher in children. Prescribing in children often requires the need for manipulation of formulations and calculation on an individual patient basis according to children’s age, weight, and body surface area. With the implementation of IPMOE on UCH’s general paediatric wards in May 2019, it provided a great opportunity to evaluate the impact of IPMOE on hospitalised children in Hong Kong.
Objectives :
The objectives of this study were to examine the impact of IPMOE on: - Safety and quality, which include the rate and nature of medication errors; - Performance of pharmacy service, with indicators such as drug delivery time and efficiency of stock control.
Methodology :
This is a quantitative, observational study conducted at general paediatric units at UCH. Pre- and post-implementation data were collected over two four-week periods. The following data were collected: i) the total number of medication orders; ii)the number and type of drug-related problems (DRPs) identified; iv) the order processing time for urgent drug orders; and v) the number of drug returns. DRPs were classified using a validated tool.
Result & Outcome :
The rates of DRP were 6.7% (n=106/1591) and 7.8% (n=157/1999) during pre- and post-phases, respectively. The difference was not significant (χ²=1.85, p = 0.21). IPMOE has eliminated hand-writing-related errors, which could potentially cause severe harm. Other types of errors were similar in nature. It was worth noting that 73% (113/155) of the DRPs during the post-phase were related to missing body weight in the system. In view of the findings, proactive action was taken with a refined data entry procedure agreed by the multidisciplinary team. As a result, this error type was reduced by 48%, thus making the reduction of overall DRPs statistically significant. Moreover, a decreasing trend in the mean urgent drug order processing time was shown (from 41 to 36 minutes). With ward returns, a reduction of 8.5% in drug cost was found (from $16,053 to $14,694), although a longer period of data collection is warranted for more in-depth evaluation.
