Risk Factors for Electronic Prescription Errors in Pediatric Intensive Care Patients

Pediatr Crit Care Med. 2020 Jun;21(6):557-562. doi: 10.1097/PCC.0000000000002303.

Abstract

Objectives: To assess risk factors for electronic prescription errors in a PICU.

Design: A database of electronic prescriptions issued by a computerized physician order entry with clinical decision support system was analyzed to identify risk factors for prescription errors.

Measurements and main results: Of 6,250 prescriptions, 101 were associated with errors (1.6%). The error rate was twice as high in patients older than 12 years than in patients children 6-12 and 0-6 years old (2.4% vs 1.3% and 1.2%, respectively, p < 0.05). Compared with patients without errors, patients with errors had a significantly higher score on the Pediatric Index of Mortality 2 (-3.7 vs -4.5; p = 0.05), longer PICU stay (6 vs 3.1 d; p < 0.0001), and higher number of prescriptions per patient (40.8 vs. 15.7; p < 0.0001). In addition, patients with errors were more likely to have a neurologic main admission diagnosis (p = 0.008) and less likely to have a cardiologic diagnosis (p = 0.03) than patients without errors.

Conclusions: Our findings suggest that older patient age and greater disease severity are risk factors for electronic prescription errors.

MeSH terms

  • Child
  • Critical Care
  • Electronic Prescribing*
  • Humans
  • Intensive Care Units, Pediatric
  • Medical Order Entry Systems*
  • Medication Errors
  • Risk Factors