[Impact of a change of computer software on prescription drug errors in an emergency department]

Changing the computer software is a known risk factor of increased prescription drug errors. The aim of this study was to evaluate the effectiveness of preventive measures to prevent these errors at our centre.

In 2007 (period 1), knowing that a change of computer software was coming, a study to determine the prescription drug errors was performed and an improvement plan was designed. Errors were classified as: type of error (indication, dosage, route of administration), severity and associated risk factors (emergency level, patient age, physician experience, day of week, time of day). Following the introduction of the new computer software (year 2009) (period 2), the same parameters were re-evaluated and compared with the previous period. All Paediatric Emergency Department (PED) reports, where some treatment was administered in the Emergency room in the same week and month for both periods, were reviewed.

A total of 615 prescriptions were written during period 1, of which 92 (15%) were classified as errors, and in period 2, 445 were written and 51 (11.5%) had errors, with no significant differences between both periods. There was a significant decrease in inappropriate indication errors (8.1% in period 1 vs 3.6% in period 2; P=.04), with no differences in dosage, route of administration and severity of errors. There was a significant error reduction in more experienced physicians, and an increase in errors by external rotation physicians (who were not skilled in the use of the new program).

The knowledge of the previous situation and the use of preventive measures ensured that errors did not increase after a change of computer software.