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Open Access 01-12-2010 | Research article

Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

Authors: Thibaut Caruba, Isabelle Colombet, Florence Gillaizeau, Vanida Bruni, Virginie Korb, Patrice Prognon, Dominique Bégué, Pierre Durieux, Brigitte Sabatier

Published in: BMC Health Services Research | Issue 1/2010

Abstract

Background

Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1) to describe the drug prescribing errors rate during the patient's stay, (2) to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (i.e. override the alert).

Methods

We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (i.e. prescribing error repeated).

Results

12 533 order lines were reviewed, 117 errors (errors rate 0.9%) were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (i.e error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error.

Conclusions

Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/10/13/prepub

Title: Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis
Authors: Thibaut Caruba
Isabelle Colombet
Florence Gillaizeau
Vanida Bruni
Virginie Korb
Patrice Prognon
Dominique Bégué
Pierre Durieux
Brigitte Sabatier
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2010
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-10-13

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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