A high rate of medical errors in prescription drug ordering, dosage and monitoring can persist at hospitals that use computerized order entry systems, according to a study published this week in the... Archives of Internal Medicine, the Salt Lake Tribune reports. In the study, conducted at the Veterans Administration Healthcare System in Salt Lake City, lead researcher Jonathan Nebecker and colleagues analyzed electronic records of 937 patients admitted to the hospital over a 20-week period in 2000. Ninety percent of patients at VA hospitals are males who tend to be older and sicker and have lower incomes than patients at other facilities. According to the study, 27% of adverse events related to prescription drugs were caused by medical errors. Of those, 61% occurred in ordering prescriptions, 25% during monitoring, 13% in administering drugs and 1% in dispensing medications. Researchers found no errors related to the transcription of prescriptions. Overall, researchers found 483 significant adverse drug events. At least one adverse event occurred in 25% of hospitalizations, including six deaths. Researchers believe the actual rate of adverse drug effects at the hospital was similar to that of other hospitals, but the numbers appear higher than in other studies because of the clarity of the computerized system. "It's not that there were more events, the measurements are better. We found that three-quarters of adverse drug effects were recognized by the computerized system," Nebecker said. He added, "People on the one hand expect computers to solve all problems. They eliminated transcription problems, but the program was not designed to detect problems with drug choice and dosing." Researchers said more sophisticated technology that can offer advice on drug choice, dosage levels and monitoring is needed at hospitals (Hamilton, Salt Lake Tribune, 5/25).

An abstract of the study is available online.

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