Marie-Caroline Loustalot1, Sarah Berdot2, Pierre Sabatier3, Pierre Durieux4, Germain Perrin5, Alexandre Karras6, Brigitte Sabatier7. 1. Pharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France. 2. Pharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France / Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France / Paris-Sud University, Faculty of Pharmacy, Clinical Pharmacy Department, Châtenay Malabry, France. 3. Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France. 4. Consultant, Pulmonologist, EPOC, Paris, France. 5. Pharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France /Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France. 6. Nephrology Department, Georges-Pompidou European Hospital, APHP, Paris, France/ Paris Descartes University, Paris, France/ INSERM, PARCC, Paris, France. 7. Pharmacy Department, Georges-Pompidou European Hospital, APHP, Paris, France / Equipe 22, Centre de Recherche des Cordeliers, UMR, INSERM, Paris, France.
Abstract
AIMS OF THE STUDY: This study assesses clinical interventions by pharmacists prospectively collected from medical and surgical wards, notably the acceptance of interventions, computerised physician order entry (CPOE)related problems, the potential impact of interventions on patient safety evaluated by a multidisciplinary committee, and their evolution over the 10 years since a first assessment. METHODS: A prospective observational study covering 13 months was conducted in a French teaching hospital with a patient information system that integrates an electronic health record (EHR) with a CPOE. Interventions by pharmacists were prospectively recorded using CPOE. All interventions were reviewed by two pharmacists. We assessed the interventions, the possible implications of the CPOE in prescribing errors, and the acceptance of interventions by physicians. A committee reviewed the potential clinical impact for patients. The results were compared with the same outcomes collected 10 years ago in the same hospital. RESULTS: A total of 2141 interventions by pharmacists were reviewed. Among them, 1589 (74.1%) were accepted by physicians. Regarding the potential clinical impact, a total of 1136 (53%) interventions concerned prescriptions that were potentially significant or serious for patients and 42 (2%) of them were potentially life-threatening. Ten years earlier, the acceptance rate was 23%. Moreover, 14.7% of errors were attributed to the use of the software, whereas 10 years earlier the rate of errors was 49%. CONCLUSIONS: The acceptance rate and frequency of CPOE-related errors were better than 10 years before, which is encouraging and shows the importance of regular training and collaboration with healthcare givers to reduce errors. The routine analysis of interventions by pharmacists with medical staff feedback should continue to improve their relevance and effectiveness.
AIMS OF THE STUDY: This study assesses clinical interventions by pharmacists prospectively collected from medical and surgical wards, notably the acceptance of interventions, computerised physician order entry (CPOE)related problems, the potential impact of interventions on patient safety evaluated by a multidisciplinary committee, and their evolution over the 10 years since a first assessment. METHODS: A prospective observational study covering 13 months was conducted in a French teaching hospital with a patient information system that integrates an electronic health record (EHR) with a CPOE. Interventions by pharmacists were prospectively recorded using CPOE. All interventions were reviewed by two pharmacists. We assessed the interventions, the possible implications of the CPOE in prescribing errors, and the acceptance of interventions by physicians. A committee reviewed the potential clinical impact for patients. The results were compared with the same outcomes collected 10 years ago in the same hospital. RESULTS: A total of 2141 interventions by pharmacists were reviewed. Among them, 1589 (74.1%) were accepted by physicians. Regarding the potential clinical impact, a total of 1136 (53%) interventions concerned prescriptions that were potentially significant or serious for patients and 42 (2%) of them were potentially life-threatening. Ten years earlier, the acceptance rate was 23%. Moreover, 14.7% of errors were attributed to the use of the software, whereas 10 years earlier the rate of errors was 49%. CONCLUSIONS: The acceptance rate and frequency of CPOE-related errors were better than 10 years before, which is encouraging and shows the importance of regular training and collaboration with healthcare givers to reduce errors. The routine analysis of interventions by pharmacists with medical staff feedback should continue to improve their relevance and effectiveness.
Authors: Emma Pinet; P Sabatier; M P Fernandez-Gerlinger; A S Jannot; J L Mainardi; B Sabatier; T Caruba Journal: Eur J Clin Microbiol Infect Dis Date: 2022-06-25 Impact factor: 3.267
Authors: Amaury Durand; André Gillibert; Sophie Membre; Lisa Mondet; Aurélie Lenglet; Aurélien Mary Journal: Front Pharmacol Date: 2022-03-23 Impact factor: 5.810