The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care
<b>Objectives</b>: To assess the impact of an electronic prescribing template with decision support upon the frequency of prescription errors, guideline adherence (relating to dose ranges), and prescription legality when prescribing continuous subcutaneous infusions (CSCI) in a palliativ...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Pharmacy |
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| Online Access: | https://www.mdpi.com/2226-4787/10/5/112 |
| _version_ | 1797470334293639168 |
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| author | Y. K. Au L. Baker J. Hindmarsh |
| author_facet | Y. K. Au L. Baker J. Hindmarsh |
| author_sort | Y. K. Au |
| collection | DOAJ |
| description | <b>Objectives</b>: To assess the impact of an electronic prescribing template with decision support upon the frequency of prescription errors, guideline adherence (relating to dose ranges), and prescription legality when prescribing continuous subcutaneous infusions (CSCI) in a palliative demographic. <b>Design, setting, and participants:</b> Before-and-after study across a large UK city utilizing local prescribing data taken from patients receiving end-of-life care. <b>Intervention:</b> An electronic prescribing template with decision support. <b>Main outcome measures:</b> The following were assessed: (1) the rate of prescription errors; (2) the proportion of prescriptions specifying a dose range and if the specified range complied with local recommendations; and (3) the proportion of prescriptions specifying legal mixing directions. <b>Results:</b> The intervention was associated with a significant reduction in errors of omission, with all prescriptions clearly stating drug indication, route of administration, drug dose, and infusion duration. The numbers of continuous subcutaneous infusion prescriptions that specified dose ranges were similar at baseline and post-intervention, at 71% (<i>n</i> = 122) and 72% (<i>n</i> = 179), respectively. At baseline, 69% (<i>n</i> = 84) of CSCI prescriptions specifying a dose range were deemed safe, and post-intervention, 97% (<i>n</i> = 173) were determined to be safe. At baseline, mixing directions were not specified correctly on any continuous subcutaneous infusion prescriptions, while post-intervention, such directions were correct on 75% (<i>n</i> = 157; <i>p</i> < 0.05) of the prescriptions. <b>Conclusions:</b> The intervention eliminated errors of omission, ensured the safety of prescribed dose ranges, and improved compliance with legislation surrounding the mixing of multicomponent infusions. Overall, the intervention has the potential to improve patient safety at the end of life and to increase the efficiency of community services. |
| first_indexed | 2024-03-09T19:35:07Z |
| format | Article |
| id | doaj.art-ee5e8107669f4d789b148ccb03368bff |
| institution | Directory Open Access Journal |
| issn | 2226-4787 |
| language | English |
| last_indexed | 2024-03-09T19:35:07Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacy |
| spelling | doaj.art-ee5e8107669f4d789b148ccb03368bff2023-11-24T01:59:23ZengMDPI AGPharmacy2226-47872022-09-0110511210.3390/pharmacy10050112The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative CareY. K. Au0L. Baker1J. Hindmarsh2South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UKSt. Benedict’s Hospice, Specialist Centre for Palliative Care, Sunderland SR2 0NY, UKSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, UK<b>Objectives</b>: To assess the impact of an electronic prescribing template with decision support upon the frequency of prescription errors, guideline adherence (relating to dose ranges), and prescription legality when prescribing continuous subcutaneous infusions (CSCI) in a palliative demographic. <b>Design, setting, and participants:</b> Before-and-after study across a large UK city utilizing local prescribing data taken from patients receiving end-of-life care. <b>Intervention:</b> An electronic prescribing template with decision support. <b>Main outcome measures:</b> The following were assessed: (1) the rate of prescription errors; (2) the proportion of prescriptions specifying a dose range and if the specified range complied with local recommendations; and (3) the proportion of prescriptions specifying legal mixing directions. <b>Results:</b> The intervention was associated with a significant reduction in errors of omission, with all prescriptions clearly stating drug indication, route of administration, drug dose, and infusion duration. The numbers of continuous subcutaneous infusion prescriptions that specified dose ranges were similar at baseline and post-intervention, at 71% (<i>n</i> = 122) and 72% (<i>n</i> = 179), respectively. At baseline, 69% (<i>n</i> = 84) of CSCI prescriptions specifying a dose range were deemed safe, and post-intervention, 97% (<i>n</i> = 173) were determined to be safe. At baseline, mixing directions were not specified correctly on any continuous subcutaneous infusion prescriptions, while post-intervention, such directions were correct on 75% (<i>n</i> = 157; <i>p</i> < 0.05) of the prescriptions. <b>Conclusions:</b> The intervention eliminated errors of omission, ensured the safety of prescribed dose ranges, and improved compliance with legislation surrounding the mixing of multicomponent infusions. Overall, the intervention has the potential to improve patient safety at the end of life and to increase the efficiency of community services.https://www.mdpi.com/2226-4787/10/5/112palliative careelectronic prescribingsubcutaneous infusionscommunity carepharmacy practice |
| spellingShingle | Y. K. Au L. Baker J. Hindmarsh The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care Pharmacy palliative care electronic prescribing subcutaneous infusions community care pharmacy practice |
| title | The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care |
| title_full | The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care |
| title_fullStr | The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care |
| title_full_unstemmed | The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care |
| title_short | The Impact of an Electronic Prescribing Template with Decision Support upon the Prescribing of Subcutaneous Infusions at the End of Life in a Community Setting: A Future Vision for Community Palliative Care |
| title_sort | impact of an electronic prescribing template with decision support upon the prescribing of subcutaneous infusions at the end of life in a community setting a future vision for community palliative care |
| topic | palliative care electronic prescribing subcutaneous infusions community care pharmacy practice |
| url | https://www.mdpi.com/2226-4787/10/5/112 |
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