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Waitemata DHB starts electronic prescription of medications

Waitemata DHB starts electronic prescription of medications

Patient safety and quality of care is to improve further at Waitemata District Health Board following the start of electronic prescribing and administration of medications.

The roll-out to 55 beds across two wards at North Shore Hospital late last month means Waitemata is the first DHB in the upper North Island to start ePrescribing.

“Patients won’t notice any difference at all to their care in hospital, but the move means that there is increased safety around the medications they are prescribed and administered,” says David Ryan, Waitemata DHB’s ePrescribing project leader.

Internationally, ePrescribing has been shown to support the entire medicines use process, providing for:

• Computerised entry and management of prescriptions, enabling easy access to information
• Computerised links between hospital wards/departments and pharmacies, and ultimately other healthcare providers (such as GPs)
• Support to healthcare professionals to make better decisions around the choice of medicines and other therapies, with automated alerts around issues such as drug interactions and dose ranges

“Electronic prescribing allows us to reduce the risk of patients experiencing avoidable issues with their medication, such as allergies or adverse reactions to certain drugs, and interactions with other drugs they may be on,” says Mr Ryan.

“For example, with ePrescribing, if a patient has a penicillin allergy recorded, the system will automatically flag up the allergy if someone attempts to prescribe them penicillin. This type of targeted alert is far superior to simply having a patient’s drug allergies listed at the top of a paper prescription.”

The initial roll-out to the two wards will be evaluated for three months before the DHB looks to expand ePrescribing to all inpatient services at North Shore and Waitakere Hospitals.

North Shore Hospital joins Taranaki and Dunedin Hospitals as collaboration pilot sites for the ePrescribing national programme, which is led by the Health Quality and Safety Commission, and the National Health IT Board.

Waitemata CEO Dr Dale Bramley says the move will further improve patient safety and quality of care at the DHB.

“The electronic prescription of medicines is another component in our commitment to providing the best care possible to every patient who comes through our doors.”

The roll-out of ePrescribing is part of the DHB’s Medications Safety Strategy, which aims to make systematic change and improvement to the way medicines are handled and used.

International research suggests that across the health sector, approximately 50% of medication harm occurs during prescribing, 40% during administration, and 10% during dispensing and distribution.

The Institute of Healthcare Improvement recommends automation and computerisation as among the most effective tools for preventing medication errors.

Waitemata DHB is considered to be a Centre of Excellence in electronic medicines management by the National Health IT Board, and has long pioneered innovation in this field.

It was one of the first DHBs in New Zealand to implement the Pyxis Medstation automated medicine distribution system in 2001, and was also an early adopter of Smart infusion pump safety software, ensuring common medicines administered by infusion pump are delivered within safe limits.

It has also done a lot of work in the area of medicine reconciliation (the process of collecting, comparing and communicating the most accurate list of all medicines that a patient is taking). An average of 2,600 patients admitted to Waitemata DHB hospitals each month have medicine reconciliation initiated, with 75% of these occurring within 24 hours of admission.

The Waitemata DHB Quality Use of Medicines team also created the SafeRx website aimed at providing succinct and up-to-date messages for health professionals about the safe use of high risk medicines. The website is linked to GP computer software, and is accessed by community based doctors, nurses and pharmacists.


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