Implementation of rules based computerised bedside prescribing and administration: intervention study

Obectives: To Implement and assess a rules based computerised prescribing s ystem with the aim of improving the safety of prescriptions and the adminis tration of drugs. Design: Analysis of performance of computerised system plus questionnaire s urvey of users. Setting: 64 bed renal unit in a teaching hospital. Intervention: Introduction of the system into routine clinical use. Main outcome measures: Number of attempted prescriptions cancelled by the s ystem; proportion of warning messages overridden; users' comparisons of the system with conventional procedures. Results: Between October 1998 and August 1999 die system cancelled 58 (0.07 %) out of 87 789 prescriptions on the grounds of clinical safety. In additi on, 427 (57%) attempted prescriptions generating high level warnings and 12 57 (8%) generating low level warnings were not completed. In a user survey 82% (31/38) of doctors and nurses considered the system to be an improvemen t on conventional procedures. Conclusions: The system has contributed to safety and patient care. All pre scriptions are complete and legible, and transcription errors have been eli minated. The system assists clinicians when they are writing a prescription by making available information on patients. The system supports clinical decision making and has been well received by doctors, nurses, and pharmaci sts.