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Friday, 17 March, 2000, 00:26 GMT
Computer weeds out unsafe prescriptions
Prescription form
Computer can check the suitability of a prescription
Scientists have developed a computer system to help medical staff check the safety of prescriptions.

In a period of 11 months, the system, pioneered by the University of Birmingham, prevented 58 unsafe prescriptions being issued.

It also gave more than 700 high level warnings about other prescription forms.

Previous studies have shown that as many as 5% of normal hand-written prescriptions may contain errors and that complications arising from drug therapy are the most common cause of adverse events among hospital patients.


The system will improve patient safety

Dr Peter Nightingale, University of Birmingham
The system is used for all prescriptions for patients at a 64-bed renal unit at the University Hospital who were suffering from kidney failure, or recovering from kidney transplantation.

Doctors, nurses and pharmacists took a wireless terminal with them on their rounds so that they could access the system from the patient's bedside.

Doctors select the drug to be prescribed for a patient and are presented with a suggested dose, frequency and duration.

The prescription is checked against patient details held in the system - including the other drugs they are on.

Warning message

The computer would issue a warning message if the subsequent prescription did not tally with the expert advice with which it had been programmed.

The user had the option of overriding the warning message, and continuing with the prescription.

However, the computer also had the capacity to disallow suspect prescriptions on clinical grounds.

Researcher Dr Peter Nightingale told BBC News Online: "Unsafe or inappropriate prescriptions can be detected at the time of prescribing and the prescriptions prevented.

"With normal hand-written prescriptions unsafe or inappropriate prescriptions will hopefully be detected at some stage but the patient may already have been given the drug, which may have had a detrimental effect on the patient.

"Thus the system will improve patient safety."

Dr Peter Hawker, chairman of the British Medical Association's consultants committee, said: "This is the kind of technology that doctors are in favour of because it is clinically useful."

Medical errors

The technology is featured in the British Medical Journal (BMJ), which this week is devoted to an investigation of medical errors.

Data from the US show:

  • The likelihood that a patient will be injured by a medical mistake in hospital is at least 3%, and probably much higher
  • There are probably 10 times as many medical errors and near misses as are actually reported
However, writing in the BMJ, James Reinertsen, chief executive of the Beth Israel Deaconess Medical Center, Boston, warns that fostering a "blame and shame" culture among doctors merely makes it more likely that errors will occur.

A separate study shows just how reluctant doctors are to admit that they are fallible.

Research by the Human Factors Research Project at the University of Texas found that consultant surgeons were almost three times as likely as pilots to deny the effects of fatigue on their performance.

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