Electronic Prescribing & Administration

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This document discusses an electronic prescribing and administration project. It outlines some of the key benefits of electronic systems like Pyxis Medstations and smart infusion pumps for improving patient safety. The project aims to implement clinical change management, decision support, and reliable infrastructure to support mobilizing staff. Key features that will be included are quicklists, allergy checking, drug interaction screening, and integration of lab results. The benefits highlighted for nurses are ward overviews and mobile access to applications, while for doctors it enables prescribing from anywhere and eliminates medicine chart rewriting.

Electronic
Prescribing &
Administration

David Ryan
on behalf of the ePrescribing Project Team

Electronic systems improving Patient safety

•Pyxis Medstations
•Bar-coding
•Smart Infusion Pumps
•Medicine Reconciliation

The problem…
Normacol granules
Augmentin tablets

Frusemide IV

Methadone

Project
• Clinical Change Management
• Local experts who understand
local practice and the system
• Intensive post go-live support
• Extensive Decision Support
• Reliable & fast infrastructure
• Mobilise staff using COWS

Drug Interactions
Erythromycin + Warfarin – a bad combination

•5000 interactions from the NZ Formulary
•Display at the point of prescribing

The Obscure Decimal Point
• Reason required to override dose range

Benefits for Nurses

• Ward Overview Screen in nursing station
• All applications available on the COWS –
i.e. Trendcare, protocols & guidelines

Benefits for Doctors

• Access to all clinical systems at the bedside
• Prescribe from any computer in the DHB
• No re-charting of medicine charts

Acknowledgements

• Wards 14 & 15 North Shore Hospital
• Pharmacy Department

• WDHB ePrescribing Project Board
• healthAlliance IS

• Project Team:

Kathleen Chudzicki, Josephine Clark, Carole Dawson, Anne
Leighton, Eryn Olshen, JB Oscongo, Adrienne Reed, Julie
Slatter, Rachana Uthaiah, Karen Valdellon

The evaluation identified several unintended consequences of the electronic prescribing pilot including new types of errors related to prescribing workflows and system defaults. Key lessons learned were that ongoing training and engagement are needed as workflows change over time. Regular monitoring is required to identify errors and develop strategies to address them, such as simplifying multi-step processes and minimizing alert fatigue. Overall the evaluation found that electronic prescribing has benefits but also risks, and a focus on how systems are implemented and used is as important as the technology itself.

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1. Electronic Prescribing & Administration David Ryan on behalf of the ePrescribing Project Team

3. Electronic systems improving Patient safety •Pyxis Medstations •Bar-coding •Smart Infusion Pumps •Medicine Reconciliation

4. The problem… Normacol granules Augmentin tablets Frusemide IV Methadone

5. Project • Clinical Change Management • Local experts who understand local practice and the system • Intensive post go-live support • Extensive Decision Support • Reliable & fast infrastructure • Mobilise staff using COWS

6. Quicklists

7. Allergies

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9. The Obscure Decimal Point • Reason required to override dose range

10. Lab Result Integration

11. Benefits for Nurses • Ward Overview Screen in nursing station • All applications available on the COWS – i.e. Trendcare, protocols & guidelines

12. Benefits for Doctors • Access to all clinical systems at the bedside • Prescribe from any computer in the DHB • No re-charting of medicine charts

13.

14. Acknowledgements • Wards 14 & 15 North Shore Hospital • Pharmacy Department • WDHB ePrescribing Project Board • healthAlliance IS • Project Team: Kathleen Chudzicki, Josephine Clark, Carole Dawson, Anne Leighton, Eryn Olshen, JB Oscongo, Adrienne Reed, Julie Slatter, Rachana Uthaiah, Karen Valdellon

15. Questions?

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