1. Electronic prescribing system design priorities for antimicrobial stewardship: a cross-sectional survey of 142 UK infection specialists
- Author
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Richard Puleston, Sandya Theminimulle, Susan Hopkins, Natalie Parker, Taryn Keyser, Andy Fox, Sean Ewings, Debbie Cumming, Adel Sheikh, Joanne Munns, Robert Porter, and Kieran Hand
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Cross-sectional study ,030106 microbiology ,Pharmacist ,Pharmacists ,03 medical and health sciences ,Patient safety ,Electronic Prescribing ,0302 clinical medicine ,Drug Utilization Review ,Anti-Infective Agents ,Electronic prescribing ,Surveys and Questionnaires ,Nominal group technique ,Health care ,Medicine ,Antimicrobial stewardship ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Intensive care medicine ,Pharmacology ,Infectious Disease Medicine ,business.industry ,Hospitals ,Infectious Diseases ,Cross-Sectional Studies ,Family medicine ,Health Care Surveys ,Respondent ,Patient Safety ,business - Abstract
Background The implementation of electronic prescribing and medication administration (EPMA) systems is a priority for hospitals and a potential component of antimicrobial stewardship (AMS). Objectives To identify software features within EPMA systems that could potentially facilitate AMS and to survey practising UK infection specialist healthcare professionals in order to assign priority to these software features. Methods A questionnaire was developed using nominal group technique and transmitted via email links through professional networks. The questionnaire collected demographic data, information on priority areas and anticipated impact of EPMA. Responses from different respondent groups were compared using the Mann-Whitney U -test. Results Responses were received from 164 individuals (142 analysable). Respondents were predominantly specialist infection pharmacists (48%) or medical microbiologists (37%). Of the pharmacists, 59% had experience of EPMA in their hospitals compared with 35% of microbiologists. Pharmacists assigned higher priority to indication prompt ( P < 0.001), allergy checker ( P = 0.003), treatment protocols ( P = 0.003), drug-indication mismatch alerts ( P = 0.031) and prolonged course alerts ( P = 0.041) and lower priority to a dose checker for adults ( P = 0.02) and an interaction checker ( P < 0.05) than microbiologists. A 'soft stop' functionality was rated essential or high priority by 89% of respondents. Potential EPMA software features were expected to have the greatest impact on stewardship, treatment efficacy and patient safety outcomes with lowest impact on Clostridium difficile infection, antimicrobial resistance and drug expenditure. Conclusions The survey demonstrates key differences in health professionals' opinions of potential healthcare benefits of EPMA, but a consensus of anticipated positive impact on patient safety and AMS.
- Published
- 2016