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Electronic Prescription

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121. Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study. Full Text available with Trip Pro

duration and clinical outcomes from electronic patient records and the hospital administrative system. We used directed acyclic graphs for statistical model selection, and analysed data with mulitvariable logistic and linear regression.We included 651 patients. Median age was 77 years [IQR; 64-84] and 46.5% were female. Median LOS was 4 days [IQR; 3-6], 30-day readmission rate was 14.4% and 30-day mortality rate was 6.9%. Penicillin G/V were empirically prescribed in monotherapy in 51.5% of patients (...) Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study. Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different

2020 BMC pulmonary medicine

122. Adherence to Prescribed E-Diary Recording by Patients With Seasonal Allergic Rhinitis: Observational Study. Full Text available with Trip Pro

Adherence to Prescribed E-Diary Recording by Patients With Seasonal Allergic Rhinitis: Observational Study. Complete diagnosis and therapy of seasonal allergic rhinoconjunctivitis require evidence that exposure to the sensitizing pollen triggers allergic symptoms. Electronic clinical diaries, by recording disease severity scores and pollen exposure, can demonstrate this association. However, patients who spontaneously download an e-diary app show very low adherence to their recording.The (...) objective of our study was to assess adherence of patients with seasonal allergic rhinitis to symptom recording via e-diary explicitly prescribed by an allergist within a blended care approach.The @IT-2020 project is investigating the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In the pilot phase of the study, we recruited Italian children (Rome, Italy) and adults (Pordenone, Italy) with seasonal allergic rhinitis and instructed them

2020 Journal of medical Internet research

123. Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK. Full Text available with Trip Pro

Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK. Oral corticosteroids (OCS) are used to manage asthma exacerbations and severe, uncontrolled asthma, but OCS use is associated with adverse effects. We aimed to describe the patterns of OCS use in the real-world management of patients with asthma in western Europe.We used electronic medical records from databases in France, Germany, Italy and the United Kingdom from July 2011 through February 2018 (...) . Patients aged ≥12 years with an asthma diagnosis, at least one non-OCS asthma medication within ±6 months of diagnosis, and available data ≥6 months prior to and ≥90 days after cohort entry were included. High OCS use was defined as OCS ≥450 mg prescribed in a 90-day window during follow-up. Baseline characteristics and OCS use during follow-up were described overall and by OCS use status.Of 702 685 patients with asthma, 14-44% were OCS users and 6-9% were high OCS users at some point during follow-up

2020 European Respiratory Journal

124. A Quality Improvement Initiative: Improving the Frequency of Inpatient Electronic Prescribing. Full Text available with Trip Pro

A Quality Improvement Initiative: Improving the Frequency of Inpatient Electronic Prescribing. To improve the frequency of electronic prescribing (e-prescribing) of discharge prescriptions at a children's hospital via a bundle of quality improvement interventions.Surveys and focus groups were conducted with patient families and pediatric residents to identify barriers and propose solutions to e-prescribing. These data were used to generate a series of interventions, including the following: (1 (...) ) provider education; (2) changes in patient registration workflow; and (3) electronic health record changes to improve the frequency of e-prescribing on the pediatric hospital medicine (PHM) service. The primary outcome measure was the e-prescribing frequency, with a balance measure of e-prescribing errors.From July 2014 through June 2015, e-prescribing frequency on the PHM service improved from a median of 7.4% to 48.9% (P < .001) and was sustained for an additional 6 months (July 2015-December 2015

2016 Pediatrics

125. Automatic Errors: A Case Series on the Errors Inherent in Electronic Prescribing. Full Text available with Trip Pro

Automatic Errors: A Case Series on the Errors Inherent in Electronic Prescribing. The adoption of electronic prescribing is on the rise, as it reduces medication errors compared to handwritten orders. The inadvertent dispensing of discontinued medications is a type of medication error that is less well described, but one that can lead to adverse events. Software for electronic prescriptions transmits orders for refills or new prescriptions, but not discontinuations, to the pharmacy. Medications (...) that have been stopped are displayed only at the prescribing facility's electronic medical record (EMR). This report describes five cases in which the pharmacy dispensed electronically discontinued medications, two of which contributed to adverse outcomes.

2016 Journal of General Internal Medicine

126. Modelling and extraction of variability in free-text medication prescriptions from an anonymised primary care electronic medical record research database. Full Text available with Trip Pro

Modelling and extraction of variability in free-text medication prescriptions from an anonymised primary care electronic medical record research database. Free-text medication prescriptions contain detailed instruction information that is key when preparing drug data for analysis. The objective of this study was to develop a novel model and automated text-mining method to extract detailed structured medication information from free-text prescriptions and explore their variability (e.g. optional (...) dosages) in primary care research databases.We introduce a prescription model that provides minimum and maximum values for dose number, frequency and interval, allowing modelling variability and flexibility within a drug prescription. We developed a text mining system that relies on rules to extract such structured information from prescription free-text dosage instructions. The system was applied to medication prescriptions from an anonymised primary care electronic record database (Clinical Practice

2016 Medical Informatics and Decision Making

127. Understanding and evaluating the effects of implementing an electronic paediatric prescribing system on care provision and hospital work in paediatric hospital ward settings: a qualitatively driven mixed-method study protocol. Full Text available with Trip Pro

Understanding and evaluating the effects of implementing an electronic paediatric prescribing system on care provision and hospital work in paediatric hospital ward settings: a qualitatively driven mixed-method study protocol. Electronic prescribing systems can improve the quality and safety of healthcare services, but their implementation is not straightforward and may create unexpected change. However, the added complexity of paediatric prescribing (eg, dose calculations, dilutions (...) , manipulations) may pose additional challenges. This study will aim to (1) understand the complex organisational reality of a paediatric hospital in which a new electronic paediatric prescribing (ePP) system will be introduced; (2) describe ePP-related change, over time, in paediatric hospital ward settings; (3) explore staff perspectives in relation to currently established practices and processes; and (4) assess the impact of ePP on care provision and hospital work from the perspective of paediatricians

2016 BMJ open

128. Optimized Computerized Order Entry can Reduce Errors in Electronic Prescriptions and Associated Pharmacy Calls to Clarify (CTC) Full Text available with Trip Pro

Optimized Computerized Order Entry can Reduce Errors in Electronic Prescriptions and Associated Pharmacy Calls to Clarify (CTC) After implementation of a system-wide EMR within our university system, e-prescribing is now commonplace.The authors conducted a study to assess whether optimization of computerized provider order entry (CPOE) can reduce errors in these electronically transmitted prescriptions and would require less frequent interventions from pharmacists, in particular the need (...) sig or demographics or (4) administration instructions had breaks or had both discrete and free text elements. Retrospectively, prescriptions were randomly selected from a nine month period before and after implementing changes. These prescriptions were analyzed by a pharmacist and a nurse to identify types of errors that would require a CTC to a prescribing provider. Errors were compared statistically to determine effectiveness of changes pre and post optimization.A total of 602 prescriptions

2016 Applied clinical informatics

129. Improving the accuracy of electronic prescribing in West Bay Health Center in Qatar Full Text available with Trip Pro

Improving the accuracy of electronic prescribing in West Bay Health Center in Qatar Primary healthcare in Qatar uses electronic prescribing to reduce the risk of medication errors. Electronic prescribing is supported by computerized Physician Order Entry systems through Cerner (electronic medical record system). There are still prescription errors, despite electronic prescribing being in place for one year at West Bay Health Center. West Bay Health Center is a famous primary healthcare center

2016 BMJ Quality Improvement Reports

130. Electronic Prescribing and Medication Management at a Residential Aged Care Facility: Uptake by General Practitioners and Qualitative Evaluation of the Benefits and Barriers Full Text available with Trip Pro

Electronic Prescribing and Medication Management at a Residential Aged Care Facility: Uptake by General Practitioners and Qualitative Evaluation of the Benefits and Barriers A cloud-based mobile electronic prescribing and medication management system (ePMMS), in which prescribers' orders directly populate residential aged care facility (RACF) medication administration records (MARs) and are communicated electronically to the RACF's pharmacy, may create efficiencies and improve patient safety (...) to access and modify residents' MARs remotely, no need for nurses to fax orders to the pharmacy, and no need for pharmacy transcription of GPs' handwritten orders to create electronic MARs. Barriers and limitations related to inefficiency, low GP uptake and training/support, and included slower prescribing compared to written orders, the need for GP-signed paper copies of the MAR, lack of integration with GP clinic software, and low GP motivation to use the system, especially GPs with few patients

2016 Applied clinical informatics

131. Risk factors for medication errors in the electronic and manual prescription Full Text available with Trip Pro

electronic records composed the sample, with 2027 prescriptions each.compared to the manual prescription, a significant reduction was observed in the risk factors after implantation of the electronic prescription, in items such as "lack of the form of dilution" (71.1% to 22.3%) and "prescription with brand name" (99.5% to 31.5%). Conversely, the risk factors "no check" and "lack of CRM of the prescriber" increased. The lack of the allergy registration and the occurrences related to medication were (...) Risk factors for medication errors in the electronic and manual prescription to compare electronic and manual prescriptions of a public hospital of Brasilia, identifying risk factors for the occurrence of medication errors.descriptive-exploratory, comparative and retrospective study. Data collection occurred from July 2012 to January 2013, using an instrument for the review of the information contained in medical records related to the medication process. A total of 190 manual and 199

2016 Revista latino-americana de enfermagem

132. 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

133. 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

134. 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

135. 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

136. 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

137. 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

138. 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

139. 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

140. 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

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