Implementation of rules based computerised bedside prescribing and administration: intervention study.

OBJECTIVES To implement and assess a rules based computerised prescribing system with the aim of improving the safety of prescriptions and the administration of drugs. DESIGN Analysis of performance of computerised system plus questionnaire survey of users. SETTING 64 bed renal unit in a teaching hospital. INTERVENTION : Introduction of the system into routine clinical use. MAIN OUTCOME MEASURES Number of attempted prescriptions cancelled by the system; proportion of warning messages overridden; users' comparisons of the system with conventional procedures. RESULTS Between October 1998 and August 1999 the system cancelled 58 (0.07%) out of 87 789 prescriptions on the grounds of clinical safety. In addition, 427 (57%) attempted prescriptions generating high level warnings and 1257 (8%) generating low level warnings were not completed. In a user survey 82% (31/38) of doctors and nurses considered the system to be an improvement on conventional procedures. CONCLUSIONS The system has contributed to safety and patient care. All prescriptions are complete and legible, and transcription errors have been eliminated. The system assists clinicians when they are writing a prescription by making available information on patients. The system supports clinical decision making and has been well received by doctors, nurses, and pharmacists.