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Electronic Prescription

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121. Electronic Alerts with Automated Consultations Promote Appropriate Antimicrobial Prescriptions Full Text available with Trip Pro

Electronic Alerts with Automated Consultations Promote Appropriate Antimicrobial Prescriptions To promote appropriate antimicrobial use in bloodstream infections (BSIs), we initiated an intervention program consisting of electronic alerts and automated infectious diseases consultations in which the identification and antimicrobial susceptibility test (ID/AST) results were reported.We compared the appropriateness of antimicrobial prescriptions and clinical outcomes in BSIs before and after (...) at 24 hours after reporting, immediately after program initiation. No significant baseline trends or changes in trends were identified. There were no significant differences in time to intravenous to oral switch therapy, length of stay, and 30-day mortality rate.This novel form of stewardship program based on intervention by infectious disease specialists and information technology improved antimicrobial prescriptions in BSIs.

2016 PloS one

122. Electronic Defaults to Reduce Opioid Prescribing in Dentistry Practices

Electronic Defaults to Reduce Opioid Prescribing in Dentistry Practices Electronic Defaults to Reduce Opioid Prescribing in Dentistry Practices - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Electronic (...) , including their co-formulations with acetaminophen. In a cluster-randomized trial of three Montefiore Medical Center dentistry sites, we will evaluate the impact of this intervention on patient-level outcomes using 18 months of data (6 months pre-intervention and 12 months post-intervention). Condition or disease Intervention/treatment Phase Acute Pain Other: Change in electronic health record default for new opioid analgesic prescriptions Not Applicable Study Design Go to Layout table for study

2016 Clinical Trials

123. Electronic Defaults to Reduce Opioid Prescribing in Emergency Department and Primary Care Settings

Phase Acute Pain Other: Change in electronic health record default for new opioid analgesic prescriptions Not Applicable Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 15000 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single (Participant) Primary Purpose: Treatment Official Title: A Cluster-randomized Trial of Modifying Electronic Health Record Defaults to Reduce the Prescribed (...) prescription ] Extracted from the electronic medical record Total opioid analgesic pills prescribed, including re-orders [ Time Frame: Within 30 days after the initial prescription ] Extracted from the electronic medical record Total morphine milligram equivalents prescribed, including re-orders [ Time Frame: Within 30 days after the initial prescription ] Extracted from the electronic medical record Outpatient visits [ Time Frame: Within 30 days after the initial prescription ] Extracted from

2016 Clinical Trials

124. Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists. Full Text available with Trip Pro

Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists. The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS).To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign

2016 Journal of Antimicrobial Chemotherapy

125. CREATING AND AUDITING A NEW ELECTRONIC CONTINUOUS INFUSION PRESCRIPTION CHART FOR A PAEDIATRIC CRITICAL CARE UNIT. (Abstract)

CREATING AND AUDITING A NEW ELECTRONIC CONTINUOUS INFUSION PRESCRIPTION CHART FOR A PAEDIATRIC CRITICAL CARE UNIT. Prescription errors, including continuous infusion prescriptions are one major source of concern in the paediatric population. Evidence suggests that use of an electronic or web-based calculator could minimise these errors. In our paediatric critical care unit (PCCU) we have created an electronic continuous infusion prescription chart to target errors in this area and conducted (...) an audit to assess its effect on error reduction.To create an electronic continuous infusion prescription chart and audit its effect on prescription errors.Similar electronic continuous infusion prescription charts were evaluated. A Choice of electronic formats were considered and excel was chosen for its simplicity and flexibility. The choice of medications to be included, dilution method, and dosage range was agreed between PCCU consultant, pharmacy and nursing staff. Formulas for calculating each

2016 Archives of Disease in Childhood

126. IMPLEMENTATION OF AN ELECTRONIC PRESCRIPTION CHART FOR GENTAMICIN FOR NEONATAL UNITS AND POSTNATAL WARDS. (Abstract)

IMPLEMENTATION OF AN ELECTRONIC PRESCRIPTION CHART FOR GENTAMICIN FOR NEONATAL UNITS AND POSTNATAL WARDS. Since the introduction of NICE guidance for Early Onset Neonatal Sepsis (EONS)1 in August 2012, the number of locally reported prescribing and administration errors involving gentamicin has increased. This guideline introduced a new, unfamiliar regimen to staff working on the Neonatal Units and Postnatal wards. Analysis of the errors suggested 36 hourly frequency of gentamicin contributed (...) to the errors due to the complexities of prescribing on the paper drug chart. Our aim was to reduce errors involving gentamicin through the introduction of a Microsoft Excel® based electronic prescription chart.Local medication incident reports for gentamicin were analysed from 1st September 2013 to 3rd October 2014 (prior to the introduction of the new prescription chart). The new prescription chart was introduced from 5 January 2015. Incident reports continued to be monitored until 30th July 2015

2016 Archives of Disease in Childhood

127. AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS. (Abstract)

AN ELECTRONIC PRESCRIPTION ALERTING SYSTEM-IMPROVING THE DISCHARGE MEDICINES PROCESS. Whilst the prescribing of both in-patient and discharge medicines is electronic, there was no automatic notification to clinical pharmacists when a discharge prescription was ready to be screened. The notification required a member of medical or nursing staff to bleep their pharmacist informing them of a prescription's availability. This manual process led to a delay in pharmacist screening which impacted (...) the email body. The email is sent to named individuals within a given distribution list. The function is scalable to support all areas using Trust eDischarge Summaries.The system was introduced in April 2015. Data from before (June 2014-January 2015) and after (June 2015) implementation was compared.Prior to the introduction of an electronic alerting system the average time from a prescriber signing a prescription to clinical pharmacist screening was 93 minutes. Three months after starting the new

2016 Archives of Disease in Childhood

128. ASSESSING THE IMPACT OF A NEWLY INTRODUCED ELECTRONIC PRESCRIBING SYSTEM ACROSS A PAEDIATRIC DEPARTMENT - LESSONS LEARNED. Full Text available with Trip Pro

ASSESSING THE IMPACT OF A NEWLY INTRODUCED ELECTRONIC PRESCRIBING SYSTEM ACROSS A PAEDIATRIC DEPARTMENT - LESSONS LEARNED. Prescribing audits have shown that the Women's and Children's Directorate reported higher number of prescription errors on the paediatric and neonatal wards compared to other areas in the Trust. Over the last three years a multidisciplinary prescribing team (PT), which included senior clinicians, pharmacists and trainees introduced a number of initiatives to improve (...) system, the ward pharmacists continued to review prescription charts on daily basis and generate regular error reports to notify the staff of new challenges.There were 174 (14%) errors out of 1225 prescriptions on 181 drug charts. The most commonly made mistakes included drug name errors, strength of preparation, allergies and ward documentation, prescriber's signature omissions, and antibiotic review and end dates. The introduction of an electronic system has eliminated drug name, strength

2016 Archives of Disease in Childhood

129. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records. Full Text available with Trip Pro

Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records. Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly (...) with regards to antibiotic prescribing and adherence to national guidelines.A descriptive study of Sweden's largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS), for the years 2008, 2010 and 2013.Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032). The antibiotic

2016 BMC Infectious Diseases

130. Improving antibiotic prescribing for uncomplicated acute respiratory tract infections

The best evidence supports the use of specific education interventions for patients/parents and clinicians, procalcitonin in adults, and electronic decision support to reduce overall antibiotic prescribing (and in some cases improve appropriate prescribing) for acute RTIs without causing adverse consequences, although the reduction in prescribing varied widely. Other interventions also reduced prescribing, but evidence on adverse consequences was lacking, insufficient, or mixed. Future studies should (...) use a complex intervention framework and better evaluate measures of appropriate prescribing, adverse consequences such as hospitalization, sustainability, resource use, and the impact of potential effect modifiers. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Acute Disease; Anti-Bacterial Agents; Humans; Prescriptions; Respiratory Tract Infections Language Published English Country of organisation United States English summary An English language summary

2016 Health Technology Assessment (HTA) Database.

131. Measuring prevalence, reliability and variation in high-risk prescribing in general practice using multilevel modelling of observational data in a population database

and Delivery Research 2015; 3(42) Authors' objectives To create prescribing safety indicators usable in existing electronic clinical data and to examine (1) variation in high-risk prescribing between patients, GPs and practices including reliability of measurement and (2) changes over time in high-risk prescribing prevalence and variation between practices. Authors' conclusions High-risk prescribing is common and varies moderately between practices. High-risk prescribing at GP level cannot be easily (...) Measuring prevalence, reliability and variation in high-risk prescribing in general practice using multilevel modelling of observational data in a population database Measuring prevalence, reliability and variation in high-risk prescribing in general practice using multilevel modelling of observational data in a population database Measuring prevalence, reliability and variation in high-risk prescribing in general practice using multilevel modelling of observational data in a population

2015 Health Technology Assessment (HTA) Database.

132. Interventions to improve appropriate antibiotic prescribing for uncomplicated acute respiratory tract infections

antibiotic use for acute respiratory tract infections (RTIs) in adults and children. Authors' conclusions . The best evidence supports the use of specific education interventions for patients/parents and clinicians, procalcitonin in adults, and electronic decision support to reduce overall antibiotic prescribing (and in some cases improve appropriate prescribing) without causing adverse consequences, although the reduction in prescribing varied widely. Other interventions also reduced prescribing (...) but evidence on adverse consequences was lacking, insufficient, or mixed. Future studies should use a complex intervention framework and better evaluate measures of appropriate prescribing, adverse consequences such as hospitalization, sustainability, and resource use and the impact of potential effect modifiers. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Anti-Bacterial Agents; Clinical Trial; Humans; Prescriptions; Respiratory Tract Infections Language Published English

2015 Health Technology Assessment (HTA) Database.

133. Evaluating the implementation of RxNorm in ambulatory electronic prescriptions. Full Text available with Trip Pro

Evaluating the implementation of RxNorm in ambulatory electronic prescriptions. RxNorm is a standardized drug nomenclature maintained by the National Library of Medicine that has been recommended as an alternative to the National Drug Code (NDC) terminology for use in electronic prescribing. The objective of this study was to evaluate the implementation of RxNorm in ambulatory care electronic prescriptions (e-prescriptions).We analyzed a random sample of 49 997 e-prescriptions that were (...) received by 7391 locations of a national retail pharmacy chain during a single day in April 2014. The e-prescriptions in the sample were generated by 37 801 ambulatory care prescribers using 519 different e-prescribing software applications.We found that 97.9% of e-prescriptions in the study sample could be accurately represented by an RxNorm identifier. However, RxNorm identifiers were actually used as drug identifiers in only 16 433 (33.0%) e-prescriptions. Another 431 (2.5%) e-prescriptions

2015 Journal of the American Medical Informatics Association

134. The effect of electronic medical record system use on communication between pharmacists and prescribers. Full Text available with Trip Pro

The effect of electronic medical record system use on communication between pharmacists and prescribers. The Electronic Medical Record (EMR) is becoming increasingly common in health care settings. Research shows that EMRs have the potential to reduce instances of medication errors and improve communication between pharmacists and prescribers; however, more research is required to demonstrate whether this is true. This study aims to determine the effect of a newly implemented EMR system (...) on the volume of communication between pharmacists and prescribers. The amount of clarification requests and incorrect dosing communications decreased after EMR implementation. This suggests that EMRs improve prescribing safety. The increased amount of refills accepted and new prescription requests post EMR implementation suggests that the EMR is capable of changing prescription patterns.

2015 BMC Family Practice

135. The impact of electronic prescribing systems on pharmacists' time and workflow: protocol for a time-and-motion study in English NHS hospitals. Full Text available with Trip Pro

The impact of electronic prescribing systems on pharmacists' time and workflow: protocol for a time-and-motion study in English NHS hospitals. Electronic prescribing (ePrescribing) systems are rapidly being introduced into National Health Systems (NHS) hospitals in England following their widespread earlier adoption into primary care settings. Such systems require substantial changes in the way pharmacists organise their work and perform their roles. There is however as yet limited evidence

2015 BMJ open

136. Postoperative analgesia for Enhanced recovery in Joint replacement: Audit of a new electronic prescribing order set Full Text available with Trip Pro

standardisation, where clinically appropriate, in the prescription of an evidence based postoperative analgesia protocol. Enhanced recovery following joint replacement has been used at this institution since 2011. An order set for the postoperative analgesia protocol was introduced to the in house electronic prescribing system in August 2014 (JAC Medicines Management; JAC Computer Services Ltd., Basildon, UK). An audit was performed to follow the effect of the new system on compliance with the postoperative (...) Postoperative analgesia for Enhanced recovery in Joint replacement: Audit of a new electronic prescribing order set Enhanced recovery in joint replacement has been shown to reduce length of inpatient stay, reduce re-admission rates, and can improve early functional recovery. Postoperative analgesia is an important component of the group of interventions required to form a holistic enhanced recovery protocol. The introduction of electronic prescribing provides the opportunity to introduce some

2015 BMJ Quality Improvement Reports

137. Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study Full Text available with Trip Pro

Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study The increase in the spread of antimicrobial resistance (AMR) in bacterial pathogens and limited availability of new antimicrobials places immense pressure on general practitioners (GPs) to prescribe appropriately. Currently, electronic antimicrobial prescribing data is not routinely collected from GPs in Ireland for surveillance purposes to assess regional specific (...) is integrated within the practice patient management software system and permitted the extraction of anonymised patient prescriptions for a one year period, from October 2012 to October 2013. The quality of antimicrobial prescribing was evaluated using the twelve ESAC drug specific quality indicators using the defined daily dose (DDD) per 1,000 inhabitants per day (DID) methodology. National and European prescribing surveillance data (based on total pharmacy sales) was obtained for a comparative

2015 BMC family practice

138. The effects of introducing an electronic prescription system with no copayments Full Text available with Trip Pro

The effects of introducing an electronic prescription system with no copayments To examine the impact of introducing an electronic prescription system with no copayments on the number of prescriptions, the size of prescriptions, and the number of visits and phone calls to primary physicians.Fixed regression models using monthly data on per capita prescriptions claims and consultations between 2009 and 2013 at the municipality level, before and after the introduction of the electronic (...) prescription system.The electronic prescription system with no copayment increased the number of prescriptions by between 6.0 and 8.1 %. It decreased the average size of each prescription, but it did not decrease the number of consultations.The reduced direct and indirect costs of obtaining prescriptions after the introduction of the electronic prescription system changed the financial incentives facing the patients and physicians. This led to significant changes in the level and size of prescriptions

2015 Health economics review

139. Challenges to the implementation of a nationwide electronic prescribing network in primary care: a qualitative study of users' perceptions. Full Text available with Trip Pro

Challenges to the implementation of a nationwide electronic prescribing network in primary care: a qualitative study of users' perceptions. The objective of this study was to identify physicians' and pharmacists' perceptions of the challenges and benefits to implementing a nationwide electronic prescribing network linking medical clinics and community pharmacies in Quebec, Canada.Forty-nine people (12 general practitioners, 2 managers, 33 community pharmacists, and 2 pharmacy staff members (...) ) from 40 points of care (10 primary care clinics (42% of all the connected sites) and 30 community pharmacies (44%)) were interviewed in 2013. Verbatim transcripts were analyzed using thematic analysis.A low level of network use was observed. Most pharmacists processed e-prescriptions by manual entry instead of importing electronically. They reported concerns about potential errors generated by importing e-prescriptions, mainly due to the instruction field. Paper prescriptions were still perceived

2015 Journal of the American Medical Informatics Association

140. Prescription Errors Before and After Introduction of Electronic Medication Alert System in a Pediatric Emergency Department. Full Text available with Trip Pro

Prescription Errors Before and After Introduction of Electronic Medication Alert System in a Pediatric Emergency Department. Prescription errors occur frequently in pediatric emergency departments (PEDs).The effect of computerized physician order entry (CPOE) with electronic medication alert system (EMAS) on these is unknown. The objective was to compare prescription errors rates before and after introduction of CPOE with EMAS in a PED. The hypothesis was that CPOE with EMAS would significantly (...) % to 58.5%). Prescribers modified 20% of the dosing alerts, resulting in the error not reaching the patient. Conversely, 11% of true dosing alerts for medication errors were overridden by the prescribers: 88 (11.3%) resulted in medication errors, and 684 (88.6%) were false-positive alerts.A CPOE with EMAS was associated with a decrease in overall prescription errors in our PED. Further system refinements are required to reduce the high false-positive alert rates.© 2015 by the Society for Academic

2015 Academic Emergency Medicine

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