Electronic Prescribing in the Neonatal Intensive Care Unit: Analysis of Prescribing Errors and Risk Factors

Area of Science:

• Neonatal intensive care
• Pharmacology
• Patient safety

Background:

• Neonatal intensive care units (NICUs) have a higher incidence of medication errors compared to adult ICUs.
• Prescribing errors constitute a significant portion of medication errors, up to 74%.

Purpose of the Study:

• To analyze prescribing errors within an electronic prescribing system.
• To identify risk factors associated with these prescribing errors in a neonatal population.

Main Methods:

• A prospective study included 240 NICU patients admitted for at least 24 hours.
• Prescriptions were generated using electronic assisted prescription software and reviewed daily by a pharmacist.
• Errors were classified using taxonomic criteria, and risk factors were analyzed.

Main Results:

• A total of 13,876 prescriptions were reviewed, with 455 errors (3.3%).
• The most frequent error type was a discrepancy between the prescription and its free-text field.
• Higher risks of errors were observed in patients with birth weights between 1000-1500g and gestational ages of 28-32 weeks.

Conclusions:

• Electronic prescribing systems can help identify prescribing errors, but process issues like complex dosing rules and free-text use remain challenges.
• Targeted interventions for specific drugs and patient demographics may further reduce errors.