CoWs get the medicine right

Central Leader - - NEWS - By MARYKE PENMAN

All it takes is shoddy hand­writ­ing on a pre­scrip­tion to cause se­ri­ous in­jury or even death.

But a shift to com­put­erised pre­scrib­ing at the Auck­land Dis­trict Health Board could im­prove pa­tient safety by tak­ing hu­man er­ror out of the equa­tion.

Doc­tors and nurses are al­ready us­ing mo­bile com­puter sta­tions across 210 beds through­out the Waitem­ata health board.

‘‘One case we’ve seen was when a doc­tor had pre­scribed 2.5mg of a med­i­ca­tion, but when the nurse read it she saw 25mg,’’ project leader David Ryan says. ‘‘The dec­i­mal point was barely leg­i­ble.

‘‘When you are po­ten­tially ad­min­is­ter­ing 10 times the pre­scribed dose be­cause of poor hand­writ­ing that’s a huge con­cern,’’ he says.

North Shore Hos­pi­tal in­tro­duced the Com­put­ers on Wheels or ‘‘ CoWs’’ in Novem­ber last year as one of three hos­pi­tals in a na­tional pi­lot. The sys­tem will be rolled out to Waitakere Hos­pi­tal by early next year.

There is no time­frame set for its im­ple­men­ta­tion through­out the Auck­land Health Board but a spokes­woman says it is a pri­or­ity.

The in­vest­ment lives, Dr Ryan says

Waitem­ata health board alone pre­scribes 4.7 mil­lion doses of medicine a year.

‘‘With that level of work­flow you are bound to see some hu­man er­ror creep in,’’ he says.



‘‘Since bring­ing in the CoWs we have seen a sig­nif­i­cant re­duc­tion in the re­port­ing of in­ci­dents.’’

Med­i­ca­tion er­rors were the third lead­ing cause of death or in­jury in New Zealand hos­pi­tals in the year end­ing June 2012, ac­cord­ing to the Health Qual­ity and Safety Com­mit­tee.

There were 91 re­ported deaths re­lated to med­i­ca­tion er­ror and a to­tal of 360 se­ri­ous in­ci­dents across the eight health boards in New Zealand.

‘‘The big thing is it has in­creased leg­i­bil­ity of pre­scrip­tions. Doc­tors’ hand­writ­ing in gen­eral is atro­cious,’’ Dr Ryan says.

The e-pre­scrib­ing soft­ware al­lows stream­lined shar­ing of pa­tient in­for­ma­tion be­tween wards, de­part­ments and phar­ma­cies.

Red flags are raised to warn if a pa­tient has an al­lergy, of po­ten­tially harm­ful drug com­bi­na­tions and if a dose ex­ceeds the safe range.

It also al­lows doc­tors to pre­scribe from any­where in the health board, not just the pa­tient’s bed­side.

Nurses say the CoWs have en­abled them to spend more time with their pa­tients as a re­sult of less pa­per­work and travel be­tween work­sta­tions.


Mo­bile meds: Waitem­ata Dis­trict Health Board e-pre­scrib­ing project leader David Ryan with nurse Anne Leighton us­ing a Com­puter on Wheels at North Shore Hos­pi­tal.

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