Background Electronic prescribing can reduce serious medication errors and improve the efficiency and quality of prescribing decisions (Hindmarsh, Holden. Int J Med Inform. 2022; 163:104777). E-prescribing was introduced for inpatients at our hospices in 2021, reducing Prescribing Safety Incidents (PSI). Paper charts continue to be used for SD prescribing, with concerns about the safety and flexibility of prescribing electronically. Case studies suggest e-prescribing of SD may reduce PSI (Au, Baker, Hindmarsh. Pharmacy. 2022; 10(5):112; Williams, Bates, Sheikh. BMJ Health Care Inform. 2020; 27(1): e100117).
Aims Assess the feasibility of prescribing SD electronically. Develop an electronic protocol for SD prescribing. Review the safety and acceptability of e-prescribing SD.
Methods Prospective review of 25 consecutive SD prescriptions and use of dose ranges. Twice-monthly meetings with digital pharmacy and nursing teams to review PSI and develop e-prescribing protocol. Initial 3-month trial period (February-May 2023). Monitoring of PSI and recording errors. Qualitative questionnaire to consider acceptability to staff.
1/61 (1.6%) prescription changes utilised dose ranges.
19/213 (8.92%) administrations incorrectly recorded in paper notes rather than electronically.
4 PSI in 3 months prior to trial (Nov 21-Feb 22), zero in trial period.
100% (8 of 8) clinical staff found e-prescribing of SD to be safe.
75% (6 of 8) wished to continue with e-prescribing, 25% (2 of 8) were uncertain.
Staff identified benefits including remote and centralised prescribing; reduced transcription errors; and ease of monitoring prescription changes.
Staff suggested further development of protocol software and formatting is necessary to ensure clarity of prescriptions and accurate administration records.
Conclusion Introducing e-prescribing of syringe drivers has been challenging, although it has provided an opportunity to review and develop current practice. E-prescribing syringe drivers is acceptable to staff and has reduced PSI, appearing to be a safe and ergonomic prescribing method. Further staff training and development of this e-prescribing protocol is required to facilitate safe and efficient prescribing and administration of syringe drivers.
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