None listed
Conditions
Brief summary
An electronic prescribing system will be implemented into three wards at Caboolture Hospital and one ward at the Royal Brisbane and Women's Hospital (RBWH) in 2018. This study will be used to assess the benefits to patients, and identify any risks or negative impacts. The aims of this project are to assess the effect of the implementation of an electronic prescribing system, including on the rates of prescribing errors, which may cause harm to patients, and may be preventable or unpreventable. The study will be an interrupted time-series study, which is conducted by acquiring a series of measurements over time, implementing the intervention (which is the electronic prescribing system), then continuing to take measurements after the intervention. This will allow comparison to determine if the electronic prescribing system can provide benefits to patient safety by reducing errors and clinical incidents. The methods used to collect the data will include review of the medical notes and medication chart, review of reported clinical incidents, and use of hospital coding data which identified an adverse effect of a medication which has occurred for a patient. A panel of pharmacists and doctors will review all of the identified incidents and potential incidents to determine the severity. The appropriateness of the medications prescribed will also be reviewed using a common tool.
Interventions
The implementation of an electronic prescribing system (MedChart version 9.1) , which will, at the time of implementation contain basic decision support (link to electronic formulary, pregnancy category X warnings), in addition to usual practice. Prescription of infusions, insulin, patient-controlled analgesia and intravenous heparin will continue to be performed on paper charts.
The implementation process will be assisted a team of specialist pharmacists, nurses and medical practitioners, pro
The implementation of an electronic prescribing system (MedChart version 9.1) , which will, at the time of implementation contain basic decision support (link to electronic formulary, pregnancy category X warnings), in addition to usual practice. Prescription of infusions, insulin, patient-controlled analgesia and intravenous heparin will continue to be performed on paper charts. The implementation process will be assisted a team of specialist pharmacists, nurses and medical practitioners, providing ongoing education prior to and several months after the actual implementation of the electronic prescribing system. Education sessions will be face-to-face and either in groups or to individuals, depending on the situation. The number and duration of sessions will be adapted to suit each medical ward and thus, is not pre-determined. The sessions will be delivered by pharmacists or nursing staff, and likewise, the most appropriate person will be adapted to suit each medical ward. The electronic system will be implemented in three medical wards at Caboolture Hospital, Queensland, Australia (a 265-bed secondary referral centre) and one geriatrics ward at Royal Brisbane and Women's Hospital (a 926-bed tertiary referral centre in Brisbane, Queensland, Australia). The electronic prescribing system will be in addition to standard care (see comparator).
Sponsors
Metro North Hospital and Health Service
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The study will be undertaken across four wards at two different hospitals; three medical wards at Caboolture Hospital and the Geriatric Evaluation and Management (GEMS) unit at Royal Brisbane and Women’s Hospital.
Exclusion criteria
Nil
Outcome results
None listed