The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment
AIMS OF THE STUDY This study assesses clinical interventions by pharmacists prospectively collected from medical and surgical wards, notably the acceptance of interventions, computerised physician order entry (CPOE)related problems, the potential impact of interventions on patient safety...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2019-02-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2579 |
| _version_ | 1798003661692993536 |
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| author | Marie-Caroline Loustalot Sarah Berdot Pierre Sabatier Pierre Durieux Germain Perrin Alexandre Karras Brigitte Sabatier |
| author_facet | Marie-Caroline Loustalot Sarah Berdot Pierre Sabatier Pierre Durieux Germain Perrin Alexandre Karras Brigitte Sabatier |
| author_sort | Marie-Caroline Loustalot |
| collection | DOAJ |
| description |
AIMS OF THE STUDY
This study assesses clinical interventions by pharmacists prospectively collected from medical and surgical wards, notably the acceptance of interventions, computerised physician order entry (CPOE)related problems, the potential impact of interventions on patient safety evaluated by a multidisciplinary committee, and their evolution over the 10 years since a first assessment.
METHODS
A prospective observational study covering 13 months was conducted in a French teaching hospital with a patient information system that integrates an electronic health record (EHR) with a CPOE. Interventions by pharmacists were prospectively recorded using CPOE. All interventions were reviewed by two pharmacists. We assessed the interventions, the possible implications of the CPOE in prescribing errors, and the acceptance of interventions by physicians. A committee reviewed the potential clinical impact for patients. The results were compared with the same outcomes collected 10 years ago in the same hospital.
RESULTS
A total of 2141 interventions by pharmacists were reviewed. Among them, 1589 (74.1%) were accepted by physicians. Regarding the potential clinical impact, a total of 1136 (53%) interventions concerned prescriptions that were potentially significant or serious for patients and 42 (2%) of them were potentially life-threatening. Ten years earlier, the acceptance rate was 23%. Moreover, 14.7% of errors were attributed to the use of the software, whereas 10 years earlier the rate of errors was 49%.
CONCLUSIONS
The acceptance rate and frequency of CPOE-related errors were better than 10 years before, which is encouraging and shows the importance of regular training and collaboration with healthcare givers to reduce errors. The routine analysis of interventions by pharmacists with medical staff feedback should continue to improve their relevance and effectiveness.
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| first_indexed | 2024-04-11T12:11:20Z |
| format | Article |
| id | doaj.art-083b2fcc03894e2f844354d3c8b52c8c |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:11:20Z |
| publishDate | 2019-02-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-083b2fcc03894e2f844354d3c8b52c8c2022-12-22T04:24:36ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972019-02-01149070810.4414/smw.2019.20015The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessmentMarie-Caroline Loustalot0Sarah Berdot1Pierre Sabatier2Pierre Durieux3Germain Perrin4Alexandre Karras5Brigitte Sabatier6Pharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, FrancePharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France; Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France; Paris-Sud University, Faculty of Pharmacy, Clinical Pharmacy Department, Châtenay Malabry, FranceEquipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, FranceConsultant, Pulmonologist, EPOC, Paris, FrancePharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France; Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, FranceNephrology Department, Georges-Pompidou European Hospital, APHP, Paris, France; Paris Descartes University, Paris, France; INSERM, PARCC, Paris, FrancePharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France; Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France AIMS OF THE STUDY This study assesses clinical interventions by pharmacists prospectively collected from medical and surgical wards, notably the acceptance of interventions, computerised physician order entry (CPOE)related problems, the potential impact of interventions on patient safety evaluated by a multidisciplinary committee, and their evolution over the 10 years since a first assessment. METHODS A prospective observational study covering 13 months was conducted in a French teaching hospital with a patient information system that integrates an electronic health record (EHR) with a CPOE. Interventions by pharmacists were prospectively recorded using CPOE. All interventions were reviewed by two pharmacists. We assessed the interventions, the possible implications of the CPOE in prescribing errors, and the acceptance of interventions by physicians. A committee reviewed the potential clinical impact for patients. The results were compared with the same outcomes collected 10 years ago in the same hospital. RESULTS A total of 2141 interventions by pharmacists were reviewed. Among them, 1589 (74.1%) were accepted by physicians. Regarding the potential clinical impact, a total of 1136 (53%) interventions concerned prescriptions that were potentially significant or serious for patients and 42 (2%) of them were potentially life-threatening. Ten years earlier, the acceptance rate was 23%. Moreover, 14.7% of errors were attributed to the use of the software, whereas 10 years earlier the rate of errors was 49%. CONCLUSIONS The acceptance rate and frequency of CPOE-related errors were better than 10 years before, which is encouraging and shows the importance of regular training and collaboration with healthcare givers to reduce errors. The routine analysis of interventions by pharmacists with medical staff feedback should continue to improve their relevance and effectiveness. https://www.smw.ch/index.php/smw/article/view/2579clinical impactcomputerised physician order entryintervention by a pharmacistprescriptions |
| spellingShingle | Marie-Caroline Loustalot Sarah Berdot Pierre Sabatier Pierre Durieux Germain Perrin Alexandre Karras Brigitte Sabatier The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment Swiss Medical Weekly clinical impact computerised physician order entry intervention by a pharmacist prescriptions |
| title | The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment |
| title_full | The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment |
| title_fullStr | The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment |
| title_full_unstemmed | The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment |
| title_short | The impact of interventions by pharmacists collected in a computerised physician order entry context: a prospective observational study with a 10-year reassessment |
| title_sort | impact of interventions by pharmacists collected in a computerised physician order entry context a prospective observational study with a 10 year reassessment |
| topic | clinical impact computerised physician order entry intervention by a pharmacist prescriptions |
| url | https://www.smw.ch/index.php/smw/article/view/2579 |
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