A Modified Outpatient Prescription Form to Reduce Prescription Errors
Abstract:Background: Given current knowledge of prescribing errors, standard paper prescription forms are inadequate for promoting high-quality outpatient prescriptions. A modified prescription form was designed and evaluated to reduce outpatient prescription errors.
Methods: Eleven providers (nine physicians, two nurse practitioners) in an adult internal medicine clinic participated in a before-after trial of a modified paper prescription form. The modified form contained prompts for medication name, form, strength, dose, route, frequency, refills, quantity, indication, and additional directions. Writing the indication has face validity and has been recommended in the literature and has been useful in the practice. Providers used the modified prescription forms for one month. Prescriptions were reviewed using the records of the outpatient pharmacy located within the same building as the clinic.
Results: A total of 443 prescriptions were reviewed during the study period; 150 (34%) were completed using modified forms. Pharmacists documented problems with 2.3% of prescriptions (9/293 standard and 1/150 modified). Modified prescription forms significantly reduced clinically important prescribing problems compared to standard forms (p = .007). Based on the legal requirements of a prescription, modified forms decreased omission errors compared to standard forms (p = .01).
Discussion: Modified prescription forms reduced clinically important prescribing problems and prescription omission errors compared to standard forms.
Document Type: Research Article
Publication date: September 1, 2004
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- Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.
David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.
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