Prescribing subcutaneous infusions
Objectives: To assess the impact of electronically prescribed mixed-drug infusions on the prevalence and types of prescription errors and staff time.
Design, setting and participants: Before-and-after study on acute medical wards of a large UK teaching hospital, utilising patient and staff data from the assessed wards.
Intervention: Electronically-generated mixed-drug infusions.
Main outcome measures: (1) Rate of prescription errors (divided into errors of commission and omission); (2) time taken to process patient discharge prescriptions containing a mixed-drug infusion; and (3) time between prescription and administration of mixed-drug infusions.
Results: 100 errors of omission were detected pre-intervention, whilst none were detected post intervention. 6 errors of commission were identified at baseline, whilst 2 were highlighted post intervention (p = 0.149). 14 physicochemically incompatible infusions were prescribed at baseline, post-intervention all infusions were compatible (p < 0.01). Time spent processing discharge prescriptions fell from 60 min (SME±1.7) to 26 min (SME± 2.7; p < 0.01). The median time from prescription to administration reduced from 120 min (95 % CI 106-150) to 65 min (95 % CI 43-85; p < 0.01).
Conclusions: The intervention eliminated errors of omission and facilitated the prescribing of compatible multicomponent infusions. Electronically prescribed mixed-drug infusions also reduced both the time taken to complete discharge prescriptions and the time taken to commence such infusions.
Hindmarsh J, Holden K. The electronic prescribing of subcutaneous infusions: A before-and-after study assessing the impact upon patient safety and service efficiency. Int J Med Inform. 2022 Apr 23;163:104777. doi: 10.1016/j.ijmedinf.2022.104777. Epub ahead of print. PMID: 35483130.