Class of 2012 Abstract / Specific Aims: Determine the incidence of scheduled co-administration times in handwritten (paper) and electronic prepared medication administration records of oral ciprofloxacin and oral moxifloxacin with interacting substances that can affect fluoroquinolone gastrointestinal absorption. Also, determine the incidence of actual co-administration of oral ciprofloxacin and moxifloxacin with interacting substances that can affect fluoroquinolone gastrointestinal absorption with electronic and handwritten prepared medication administration records. Methods: Retrospective data was obtained by a chart review of patients from an academic medical center for a one month period before (May 2010) and after (August 2010) implementation of an electronic prepared medical administration record system. The scheduled time and actual time given for all fluoroquinolone antibiotics, as well as all possible interacting substances, were recorded. Main Results: A total of 99 subjects were included in this study (36 paper and 63 electronic). There was no statistical difference (p=0.47) between the percentage of scheduling errors for the electronic prepared medication administration records, 25.3%, compared to the paper medication administration records, 22.1%. However, there was a decrease in the percentage of actual co-administrations of fluoroquinolones with interacting substances for the electronic prepared MARs compared to paper prepared medication administration records; 22.3% and 32.1% respectfully (p=0.03). Conclusions: After implementing electronic prepared medication administration records at an academic institution, co-administration errors went down even though the amount of scheduling errors did not decrease.

Sammanfattning Syftet med föreliggande arbete var att studera förekomsten av felaktiga läkemedelsordinationer på en pediatrisk avdelning. Metoden bestod i journalgranskning av läkemedelsordinationer av inskrivna patienter (n = 94) under två månader, 2012. Journalgranskningen utfördes i journaldatabasen Cosmic och omfattade 543 läkemedelsordinationer vilka granskades utifrån flertalet variabler. Resultatet visade att 174 av 543 (32 %) ordinationslistor var felaktiga. Läkemedelsnamn samt hänvisning till speciallista var angivet i samtliga ordinationer. Läkemedelsform var angivet i majoriteten av läkemedelsordinationerna. Styrka var ej angivet i 1 %, dos var ej angivet i 2 %, administrationssätt var felaktigt angivet i 6 % och var ej angivet i 9 %, administrationstidpunkt var ej angivet i 2 %. Maxdos för vid behovsläkemedel var ej angivet i 35 % och spädningsschema eller hänvisning till spädningsschema var ej angivet i 10 % av läkemedelsordinationerna. Slutsatsen visar att de vanligaste felaktigheterna bestod i administrationssätt, maxdos för vid behovsläkemedel samt spädningsschema eller hänvisning till spädningsschema. Alla felaktigheter i läkemedelsordinationen har påverkan på arbetssituationen för sjuksköterskan i såväl handhavandet av läkemedel, tidsåtgång samt resurser inom vården, vilket äventyrar patientsäkerheten. / Abstract The aim of the study was to investigate the incidence of drug prescription errors at a pediatric ward facility. The method used consisted of medical record review of drug prescription errors of enrolled patients (n = 94) for two months during 2012. Medical record review was performed and included 543 drug prescriptions, which were evaluated. The results showed that 174 of 543 (32 %) of prescription lists were incorrect, based on information given with the medication. The study found that drug name and reference to the specialist were always provided. However, errors included: dosage form not specified in 0.4%, strength was not specified in 1.1%, dose was not specified in 1.6%, route of administration was incorrectly stated in 5.9% and was not specified in 8.8%, administration time was not specified in 1.7%. Maximum dose for range order was not specified in 34.9% and dilution scheme or reference to dilution scheme was not specified in 9.6%. The conclusion of the study was that the most common prescription errors consisted of route of administration, the maximum dose if necessary drugs and dilution scheme or reference to dilution scheme. Prescription errors have effects in the workplace for nurses in the administration of drugs, which threatens patient safety.