Academic literature on the topic 'Medication errors – Prevention'

Introduction This thesis looks at the pharmacist’s contribution to the capture of medication errors and preventing harm reaching patients. It has several components: an analysis of annual surveys of interventions made by pharmacists at a large teaching hospital, a re-coding of these surveys to see how many interventions were the result of prescribing errors, and an experiment in A&E where the pharmacist drafted the first prescription chart. Methods One-week surveys of pharmacist interventions were regularly made at Southampton General Hospital between 1999 and 2009. These were analysed for trends, then recoded to identify the proportion that were caused by prescribing errors. In addition, a controlled trial was conducted to investigate the effects on prescribing error rate, of a pharmacist obtaining an accurate medication history in A&E, then transcribing the data onto the first inpatient prescription. Key findings In the period 1999-2001, the average number of interventions in each week long survey was 575 and during 2005-9 it was 973. This was a statistically significant increase. More interventions were recorded as serious in the latter period. The rate of interventions also increased from between one per every five and seven patients (31 to 45 prescribed items) to one per every one to two patients (8 to 20 items). The severity of interventions also increased, with between one and five deaths avoided each week. Almost three quarters of pharmacists’ interventions (73.9%) were triggered by prescribing errors, giving an error rate of 644 prescribing errors per week, or 6.2 per 100 prescribed items. These data are in contrast to the Trust submitting 918 error reports per year to the NPSA, the majority of which were administration errors reported by nurses. Nearly a half (45.3%) of all prescribing errors occurred during the admission phase of the hospital episode. Two thirds (67.1%) of prescribing errors detected were errors of omission - things that had not been done. Prescribing errors of commission occurred mainly during the inpatient phase and errors of omission during the admission phase. A quarter of prescribing errors were planning errors. These were failures to follow guidelines, failures to review patients’ prescriptions, manage interactions, and adjust dosage in liver or renal failure or in response to TDM results. One fifth (21.7%) of the patients had events or symptoms that contributed to the admission that could be explained by the medicines they were consuming. Over half of these were potentially avoidable by better monitoring or product selection. A pharmacist working in A&E to obtain complete and accurate drug histories, then transcribing the data onto the first prescription, produced a trend to reduction in the generation of errors throughout the whole hospital episode. Conclusions Analysing pharmacist’s interventions is a useful method of investigation prescribing errors and ways to stop them happening. First prescriptions written by pharmacists should provide an effective means of reducing errors which may be promulgated throughout the hospital stay.

The number of deaths due to medical errors in hospitals ranges from 44,000 to 98,000 yearly. More than 7,000 of these deaths have taken place due to medication errors. This project evaluated the implementation of an automated medication dispensing cabinet or PYXIS machine in a 25-bed upper Midwestern critical access hospital. Lewin's stage theory of organizational change and Roger's diffusion of innovations theory supported the project. Nursing staff members were asked to complete an anonymous, qualitative survey approximately 1 month after the implementation of the PYXIS and again 1 year later. Questions were focused on the device and its use in preventing medication errors in the hospital. In addition to the surveys that were completed, interviews were conducted with the pharmacist, the pharmacy techs, and the director of nursing 1 year after implementation to ascertain perceptions of the change from paper-based medication administration to use of the automated medication dispensing cabinet. Medication errors before, during, and after the PYXIS implementation were analyzed. The small sample and the small number of medication errors allowed simple counts and qualitative analysis of the data. The staff members were generally satisfied with the change, although they acknowledged workflow disruption and increased medication errors. The increase in medication errors may be due in part to better documentation of errors during the transition and after implementation. Social change in practice was supported through the patient safety mechanisms and ongoing process changes that were put in place to support the new technology. This project provides direction to other critical access hospitals regarding planning considerations and best practices in implementing a PYXIS machine.

Medication errors cause harm, yet most of them are preventable (Institute of Medicine, 2006). Nurses spend 40% of their time administering medications; therefore they play a key role in the reduction of medication errors. Little empirical evidence has been collected about the effectiveness of nursing education in reducing medication errors committed by nursing students. Traditional educational interventions focus on the five rights of medication administration; however, the literature shows that interventions focused on instilling a culture of safety have a greater impact on reducing medication errors. The purpose of this article is to review educational strategies that have been implemented and tested in pre-licensure nursing programs to reduce medication errors committed by nursing students.

Medication administration constitutes a key element of acute care delivery, while errors in the process threaten patient safety. The purpose of the study is to explore patients’ perceptions, attitudes and beliefs about the safety practices utilized by nurses when administering medications. Specifically, the study addresses patients’ perceptions of nurse behaviours regarding safe medicine administration, patient behaviours, patients’ perceptions and nurse behaviours regarding pain medicine, patients’ perceptions of nursing care, and patients’ perceptions of their participation/accountability in care. The results identify key safety issues from a patients’ perspective to focus change strategies that will improve patient care.<br>x, 125 leaves ; 29 cm

Syfte: Syftet med studien var att beskriva vilka faktorer som kan orsaka risk för fel i samband med sjuksköterskans läkemedelshantering samt vad sjuksköterskan kan göra för att förebygga att fel uppstår inom den somatiska slutenvården. Syftet var också att granska artiklarnas kvalité utifrån urval och bortfall. Metod: En beskrivande litteraturstudie som baseras på 13 vetenskapliga artiklar med både kvalitativ och kvantitativ ansats. Litteratursökningen genomfördes i databaserna PubMed, Cinahl och Academic Search Elite. Resultat: Faktorer som orsakade att sjuksköterskan begick fel i läkemedelshanteringen var hög arbetsbelastning, bristande kunskaper inom farmakologi, mindre erfarenhet av sjuksköterskeyrket och avbrott i arbetet. Förebyggande åtgärder för att minimera risken att ett fel uppstod i samband med läkemedelshanteringen var att sjuksköterskan ökade sina kunskaper i farmakologi, bidrog till förbättrad arbetsmiljö och kommunikation med annan vårdpersonal samt var nogrannare vid kontroller. Slutsats: Flera förekommande faktorer som orsakade fel i samband med sjuksköterskans läkemedelshantering som hög arbetsbelastning och bristande kunskaper inom farmakologi borde inte vara svåra att förebygga. Det stora förebyggande arbetet bör ske inom verksamheten för att förbättra arbetsmiljön för sjuksköterskorna och på så vis minska att fel uppstår i samband med läkemedelshanteringen.<br>Aim: The purpose of this study was to describe the factors that could cause errors associated with the nurse's medication and what the nurse can do to prevent errors from occurring in somatic inpatient care. The aim was also to examine the quality of the articles in relation to sample size and disappearance. Method: A descriptive literature study based on 13 scientific articles with both qualitative and quantitative approach. The literature research was made in the databases PubMed, Cinahl and Academic Search Elite. Results: Factors that caused the nurse to made ​​errors in the handling of drugs was high workload, lack of knowledge in pharmacology, less experience in the nursing profession and working interruptions. Preventive measures to minimize the risk that an error occurred during the drug treatment were that the nurse increased her knowledge of pharmacology, contributed to a better working environment and the communication with other healthcare professionals and was accurate at the controls. Conclusion: Several common factors that caused the errors associated with the nurse's medication as high workload and insufficient of knowledge in pharmacology should not be difficult to prevent. The major preventive measures should be done within the hospital management to improve the working environment for nurses and prevent the error associated with medication management.

L’iatrogénie induite par les erreurs médicamenteuses est un problème majeur de santé publique. Ce travail a pour objectif de développer une approche systémique visant à réduire leur occurrence en cancérologie. L’étude est menée aux Hospices Civils de Lyon au sein du Groupement Hospitalier Sud. L’analyse des erreurs médicamenteuses interceptées, sur une période de 5 ans, révèle que 4 prescriptions de chimiothérapie sur 100 présentent au moins une erreur médicamenteuse, dont plus de la moitié sont des erreurs de dose. Les facteurs de risque d’erreurs de prescription identifiés sont la prescription par un interne, l’hospitalisation conventionnelle, le patient ayant une surface corporelle supérieure à 2 m², les protocoles de plus de trois médicaments anticancéreux, comprenant du carboplatine ou nécessitant une modification par le prescripteur. L’évaluation de la gravité clinique potentielle des erreurs médicamenteuses montre que 13,4% d’entre elles auraient causé un préjudice temporaire et 2,6% un préjudice permanent. Le pronostic vital aurait été engagé dans 2,6% des cas conduisant au décès pour 6 patients sur une période d’un an. L’évaluation médico-économique permet d’estimer le coût pour l’assurance maladie d’une erreur médicamenteuse en cancérologie avec conséquences cliniques à 1 523€ associé à 3,5 journées d’hospitalisation supplémentaires. Cette approche systémique conduit au développement de revues d’erreurs médicamenteuses et de morbi-mortalité, socle de l’analyse collective indispensable à la prévention du risque médicamenteux en cancérologie<br>Medication errors are a major public health problem. This work aims to develop a systemic approach to reduce their occurrence in oncology. The study was conducted in Groupement Hospitalier Sud (Hospices Civils de Lyon). The analysis of intercepted medication errors, over a period of five years, reveals that four out of 100 prescriptions of chemotherapy include at least one medication error, which over half are dose errors. Risk factors of prescribing errors identified are prescription by a resident physician, inpatient care, patient with a body surface area greater than 2 m², protocol with more that three anticancer drugs, protocol involving carboplatin or protocol requiring at least one modification by the physician. 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage. The vital prognosis of the patient would have been compromised in 2.6% of cases leading to death for six patients over a period of one year. The cost of one medication error with clinical consequences was estimated at € 1 523 associated to 3.5 additional days of hospitalisation. This approach led to the development of systematic medication errors reviews and morbi-mortality conferences that allow a collective and multidisciplinary analysis to enhance the patient’s safety

Parkinson' Disease (PD) is a motor disorder characterized by rigidity, tremor, and hypokinesia with secondary manifestations like defective posture and gait, mask like face and dementia. Over the years it may lead to inability to move, breath and ultimately patient may succumb to chest infection and embolism. Prevalence studies show that more than six million people around the world suffer from PD. At present, there is no cure for PD but there are effective treatments that can slow the progression of the disease and regulate its affects. PD results from a deficiency of dopamine so most drugs that produce a salutary effect in PD either potentiate dopamine or work as dopamine agonists. Hence, to keep the symptoms of PD to a minimum it is very important that the medications be consumed regularly, so that the dopamine level is maintained in the body of the subject. Electronic pillbox logger is a device that has been designed to ensure this very much required medication adherence in PD subjects, which can also be used to measure the response to oral medication. This work describes the design and implementation of an electronic pillbox logger for use by people suffering from Parkinson's disease (PD). The pillbox logger is designed to track medication adherence and prompt the user to take medication on time. It is pocket-sized, portable, and compartmented. It has a variety of alarm systems to remind the user to take the correct dose of their medication at the correct time. Most importantly, it keeps an electronic log of the time of dosage consumption by detecting the presence/absence of pills in the pillbox. This overcomes major limitations of other pillboxes with a logging function that are often too large to carry, contain a single compartment, or only record the time the container was opened rather than the presence or absence of pills. The proposed pillbox logger complements a wearable device under development for people with Parkinson's disease that continuously monitors impaired movement. The combination of the pillbox logger with the wearable sensor will permit clinicians to determine the response to oral therapies, which can be used to optimize therapy. People with PD consume similar pills throughout the day hence the pillbox logger has been designed to detect the presence/absence of pills in general in the pillbox rather than which specific pills are absent or present in the pillbox logger. This feature of the current design that the device records knowledge about pills in general in the pillbox logger and not about any specific pills is a major reason why the current design is specific to PD subjects only. However, though the current design of the pillbox logger is designed for people with Parkinson's Disease, the pillbox is suitable for other maladies in which the timing of the medication is critical. The described pillbox logger was built and the design was validated after running a number of tests. The battery powered pillbox logger is able to accurately store the information about the actual presence/absence of pills in each compartment of the pillbox. It is capable of sending out reminder alarms at the right time of the day and can be connected to a host computer using a USB cable to read the stored information from it. The proper functional working of the pillbox logger after thorough testing proves that the design of pillbox logger was successful.

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-05-19T13:23:49Z No. of bitstreams: 1 renatapradobvilela_dissert.pdf: 4967278 bytes, checksum: 7bd89c0f78df57cc9c83d2e2b2dd976d (MD5)<br>Made available in DSpace on 2017-05-19T13:23:49Z (GMT). No. of bitstreams: 1 renatapradobvilela_dissert.pdf: 4967278 bytes, checksum: 7bd89c0f78df57cc9c83d2e2b2dd976d (MD5) Previous issue date: 2016-09-16<br>Introduction: Medication error is a frequent event in health and it may have consequences for the patient, professional, institution, and health system. Currently, many technologies can prevent it. However, it requires financial and professional investment to break down the barrier to make these technologies effective. Objectives: Analyze the scientific production related to the cost of medication errors in the stages of the medication therapy chain; Investigate the occurrence of medication errors; Map and validate the use of established technologies that prevent medication errors; Characterize the training related to medication error prevention and to verify the nursing staff compliance to such training; and analyze the costs of the technologies employed to prevent medication error and its impact on a teaching hospital. Methods: Initially, we performed an integrative literature review (2005-2015). A case study was carried out to calculate the incidence indicator of medication error from the equation proposed by the Commitment to Hospital Quality and document analysis from 2007 to 2015. We used as a data source to map and validate preventive technologies, document analysis and interviews. Subsequently, we drew up flowcharts of the medication process in the medication therapy chain, including preventative technologies at every stage. The validation of these flowcharts occurred through interviews with 26 professionals. We carried out a document analysis of practices performed at the integrated center of permanent education in health, as well as the adherence of the nursing staff to practice through the ratio of professionals working in the respective years. We calculated the direct costs of each technology in the medication therapy chain by multiplying the estimated time spent by the personnel in each activity by its cost, adding to the unit cost of inputs multiplied by the amount of the technology acquisition. The impact of technologies was verified from the historical series associated to the incidence indicator of medication error in relation to the time of implementation of technologies in the field of study. Results: We analyzed 14 articles, with a predominance of evidence level 6, through both the hierarchical system (78.5%) and economic evaluations (50%). Among the articles, five were related to drug prescription, one to medication therapy management, one to drug prescription and medication therapy management, and seven included all stages of the medication therapy chain. There was a great mismatch of values presented in the estimation of avoidable cost/medication error, ranging from US$ 9, 041.76 to US$ 5,095,640,000.00. The incidence of medication error was 1.4%. The main type of mistake was “omission” (31.2%). Inpatient units were the most ones that notified the error (53.3%). The main cause-related error was “inattention” (93.3%). The work process cause-related error has not been notified (80%). The decision-making after the error was “individual counseling” (71.1%). The process of the medication therapy chain was divided into three sub-processes (prescription, dispensing, and management) including 50 nursing activities. One of the technologies for the prevention of medication errors was mentioned during the practice training. One hundred and twelve practice trainings were offered from 2011 to 2013. These practice trainings were related to medication errors. Most of the participants were nursing auxiliaries/licensed practical nurses (6.804; 69.3%, respectively). However, the adhesion of nurses (7.5%) was higher than that of technical personnel. The main thematic axis addressed axis and that with greater adherence of the nursing staff was “medication process” (19; 17%; 49.6%). We could identify 13 technologies established to prevent medication errors. The average cost/year of these technologies per patient was R$ 55,75 (US$ 13.94) with an annual projection of R$ 10.259.505,10 (US$ 2, 598, 361.55). The average investment per patient in preventive technologies related to the stage of drug prescription was R$ 17,67 (US$ 4.42). Regarding dispensation, the investments reached R$ 16,19 (US$ 4.05), and related to medication therapy management it was R$ 21,89 (US$ 5.47 ). The incidence indicator of medication error showed a gradual decreased from 2007 to 2013 ranging from 2.4% to 0.4%. Conclusion: Medication Errors can be costly at all stages of the medication therapy chain. However, the literature lacks research with a best level of evidence. Medication error indicator is feasible, and it serves as a tool to the manager in the decision-making process. It also helps to establish preventive strategies. The management of the error is still focused on the human error and not to the process failure. This may be the reason for the underreporting of the problem. The process of the medication therapy chain is complex and several professional categories are involved in it. There are several technologies for medication error prevention. However, these require financial investment for the acquisition and awareness/commitment of the nursing personnel to use it. Thus, it can be inferred that there was an improvement in patient safety, once there was a positive impact of the investment in preventive technology in relation to the decrease in medication error indicator as displayed in time series studies.<br>Introdução: O erro de medicação é um evento frequente na área da saúde e pode ter consequências para o paciente, profissional, instituição e sistema de saúde. Atualmente, existem muitas tecnologias que podem preveni-lo, no entanto, demandam investimento financeiro e profissional para que a barreira seja efetiva. Objetivos: Analisar a produção científica relacionada ao custo dos erros de medicação nas etapas da cadeia medicamentosa; investigar a ocorrência de erros de medicação; mapear e validar a utilização das tecnologias implantadas que previnem o erro de medicação; caracterizar os treinamentos relacionados à prevenção do erro de medicação e verificar a adesão da equipe de enfermagem a esses treinamentos e; analisar os custos das tecnologias empregadas para a prevenção do erro de medicação e o seu impacto em uma instituição hospitalar de ensino. Método: Inicialmente foi realizada uma revisão integrativa (2005 a 2015), depois, um de estudo de caso em um hospital escola de nível quaternário, porte extra, do interior de São Paulo, para o cálculo do indicador de incidência de erro de medicação a partir da equação proposta pelo Compromisso com a Qualidade Hospitalar e análise documental no período de 2007 a 2015. Para mapear e validar as tecnologias preventivas foram utilizados como fonte de dados a análise documental e entrevista. Posteriormente, desenharam-se os fluxogramas do processo de medicação na cadeia medicamentosa, incluindo as tecnologias preventivas em cada etapa. A validação desses fluxogramas ocorreu por meio de entrevista com 26 profissionais. Foi realizada a análise documental dos treinamentos realizados pelo centro integrado de educação permanente em saúde, bem como a adesão da equipe de enfermagem aos treinamentos por meio da proporção de profissionais atuantes nos respectivos anos. Calculou-se o custo direto de cada tecnologia na cadeia medicamentosa, multiplicando-se o tempo estimado despendido da mão de obra em cada atividade pelo seu custo, somando-se o custo unitário dos insumos multiplicado pela quantidade da aquisição da tecnologia. O impacto das tecnologias foi verificado a partir da série histórica do indicador de incidência de erro de medicação em relação aos momentos de implantação das tecnologias no campo de estudo. Resultados: Foram analisados 14 artigos, com predomínio do nível 6 de evidência, tanto pelo sistema hierárquico (78,5%) quanto para avaliações econômicas (50%). Dentre os estudos, cinco estavam relacionados à prescrição, um à administração, um à prescrição e administração e sete contemplavam todas as etapas da cadeia medicamentosa. Houve grande assimetria de valores apresentada na estimação de custo evitável/erro de medicação, variando de US$9, 041.76 a US$5,095,640,000.00. A incidência de erro de medicação foi de 1,4%. O principal tipo de erro foi “omissão” (31,2%). As unidades de internação foram as que mais notificaram (53,3%). A principal causa relacionada ao erro foi “desatenção” (93,3%) e ao processo de trabalho não foi notificada (80%). A ação realizada após o erro foi “aconselhamento individual” (71,1%). O processo da cadeia medicamentosa foi dividido em três subprocessos (prescrição, dispensação e administração) contemplando 50 atividades. Uma das tecnologias para a prevenção do erro de medicação citada foi os treinamentos, no período de 2011 a 2013 foram ministrados 112 treinamentos relacionados ao erro de medicação, a maior parte dos participantes eram auxiliares/ técnicos de enfermagem (6.804; 69,3%), no entanto, a adesão dos enfermeiros (7,5%) foi superior à de nível técnico. O principal eixo temático abordado e com maior adesão da equipe de enfermagem foi “processo de medicação” (19; 17%; 49,6%). Para prevenção do erro de medicação foram identificadas 13 tecnologias implantadas. O custo médio/ano dessas tecnologias por paciente foi de R$ 55,75 (US$ 13.94), com projeção anual de R$ 10.259.505,10 (US$ 2,598,361.55). O investimento médio por paciente em tecnologias preventivas para a etapa da prescrição foi de R$ 17,67 (US$ 4.42), na dispensação R$ 16,19 (US$ 4.05) e na administração R$ 21,89 (US$ 5.47). O indicador de incidência de erro de medicação apresentou queda gradual entre os anos de 2007 a 2013 variando de 2,4% a 0,4%. Conclusão: Erros medicação podem ser custosos em todas as etapas da cadeia medicamentosa, no entanto a literatura carece de pesquisas com melhor nível de evidência. O indicador de erro de medicação é exequível e instrumentaliza o gestor na tomada de decisão e estabelecimento de estratégias preventivas. A gestão do erro ainda está voltada para a falha humana e não do processo, podendo ser este o motivo da subnotificação deste problema. O processo da cadeia medicamentosa é complexo e há participação de várias categorias profissionais. Existem várias tecnologias para prevenção do erro de medicação, no entanto demanda investimento financeiro para sua aquisição e conscientização/comprometimento profissional na utilização. Assim, pode-se inferir que houve melhoria da segurança do paciente, uma vez que o impacto positivo do investimento em tecnologias preventivas em relação à diminuição do indicador de erros de medicação na série histórica apresentada.

Det övergripande syftet med den här avhandlingen har varit att, inom området läkemedelsinformatik, studera utvecklingen av elektroniska stöd inom läkemedelsförskrivning; för klinisk praxis, uppföljning och forskning. Under århundraden har det handskrivna receptet varit det sätt, med vilket läkare förmedlat sina läkemedelsordinationer till apotekare, vilket också för patienten blivit en informationskälla för hur läkemedel ska användas för att göra bästa nytta. Nu genomgår receptet en förändring från pappersbaserat till elektroniskt meddelande och att anpassa en traditionell process till en ny elektronisk era innebär både möjligheter och utmaningar. Studierna som ingår i avhandlingen har visat att exponeringen av förskrivna läkemedel i en allmän befolkning har ökat under de senaste tre decennierna. Risken för potentiella interaktioner mellan läkemedel, varmed avses den risk som finns att olika läkemedel kan påverka varandras effekter och biverkningar, har också visat sig öka starkt desto fler läkemedel som används av en individ. Denna ökade samtidiga användning av flera olika läkemedel, så kallad polyfarmaci, medför att det finns en större anledning för förskrivare och farmacevter att uppmärksamma risken för potentiella interaktioner mellan läkemedel. De nyinrättade nationella receptregistren över uthämtad receptförskriven medicin bör användas bland annat för att upptäcka potentiella läkemedelsinteraktioner, såväl i vårdens utövning som inom läkemedelsepidemiologisk forskning. Den svenska läkemedelsförteckningen, som omfattar information om uthämtade receptförskrivna läkemedel för huvuddelen av den svenska befolkningen, bedöms ha en stor klinisk potential. Den enskilde individens historiska information om uthämtade läkemedel är tillgänglig för individen på Internet med hjälp av e-legitimation; även förskrivare och farmacevter på apotek kan ta del av informationen med den enskildes samtycke. Brist på tillgång till enhetliga och säkra autenticeringsmetoder inom hälso- och sjukvården kan dock fördröja tillgången på individuell läkemedelsinformation för förskrivare. I och med att de flesta recepten i Sverige nu skrivs och överförs elektroniskt är det viktigt att kvalitetsmässiga aspekter tas tillvara så att en iakttagen ökad risk för receptförskrivningsfel inte överförs i informationskedjan. Avhandlingens slutsats är att e-förskrivning, med kommunikation och användning av lagrad information om receptexpeditioner, möjliggör att läkemedelsbehandling som process kan följas och studeras på ett helt nytt<br>The thesis aimed to study the developments, in the area of pharmacoinformatics, of the electronic prescribing and dispensing processes of drugs - in medical praxis, follow-up, and research. For hundreds of years, the written prescription has been the method of choice for physicians to communicate decisions on drug therapy and for pharmacists to dispense medication. Successively the prescription has also become a source of information for the patient about how to use the medication to maximize its benefit. Currently, the medical prescription is at a transitional stage between paper and web, and to adapt a traditional process to the new electronic era offers both opportunities and challenges The studies in the thesis have shown that the exposure of prescribed drugs in the general population has increased considerably over three decades. The risk of receiving potentially interacting drugs was also strongly correlated to the concomitant use of multiple drugs, polypharmacy. The pronounced increase in polypharmacy over time constitutes a growing reason for prescribers and pharmacists to be aware of drug interactions. Still, there were relatively few severe potential drug interactions. Recently established national prescription registers should be evaluated for drug interaction vigilance, both clinically and epidemiologically. The Swedish National Pharmacy Register provides prescription dispensing information for the majority of the population. The medication history in the register may be accessed online to improve drug utilization, by registered individuals, prescribers, and pharmacists in a safe and secure way. Lack of widespread secure digital signatures in healthcare may delay general availability. With a relatively high prevalence of dispensed drugs in the population, the National Pharmacy Register seems justified in evaluating individual medication history. With a majority of prescriptions transferred as ePrescriptions, the detected increased risk for prescription errors warrants quality improvement, if the full potential of ePrescriptions is to be fulfilled. The main conclusion of the studies was that ePrescribing with communication of prescribed drug information, storing and retrieving dispensed drug information, offers new opportunities for clinical and scientific

Thesis (M.S.)--State University of New York at Binghamton, Thomas J. Watson School of Engineering and Applied Science, Department of Systems Science and Industrial Engineering, 2009.<br>Includes bibliographical references.