Factors contributing to electronic prescribing errors in healthcare settings: a qualitative study

Area of Science:

• Health Informatics
• Patient Safety Research
• Medication Error Analysis

Background:

• Illegible handwritten prescriptions cause medication errors, impacting patient safety and healthcare costs.
• Electronic prescribing (E-prescribing) systems aim to mitigate these errors but can introduce new ones.
• This study investigates E-prescribing error factors in Iranian outpatient centers.

Purpose of the Study:

• To analyze the contributing factors to medication errors within E-prescribing systems.
• To identify specific system, human, organizational, and medication-related issues.
• To inform strategies for reducing E-prescribing errors and enhancing patient safety.

Main Methods:

• A qualitative content analysis approach was employed.
• Data were gathered through interviews with 10 healthcare professionals experienced in E-prescribing.
• Interviews were coded and analyzed using the Graneheim and Lundman methodology.

Main Results:

• Four primary error categories were identified: system, human, organizational, and medication-related.
• System issues included problematic autocomplete features; human factors involved prescriber fatigue and reduced interaction time.
• Organizational deficiencies like insufficient training and staffing, alongside medication-specific issues (e.g., look-alike names), contributed to errors.

Conclusions:

• E-prescribing errors arise from a complex interplay of factors affecting all prescribers.
• Improving system design and user training is necessary but insufficient; the sociotechnical context must be addressed.
• Recommendations include standardized protocols, decision support systems, and continuous professional development for enhanced usability and safety.