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Research Article
Boris Zevin
Queen’s University
Corresponding Author
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Background
Medication prescribing errors are a source of morbidity and mortality on surgical wards, however educational interventions with proven effectiveness to reduce these errors are lacking. Our objective was to design, implement, and assess the effectiveness of a curriculum designed to reduce medication prescribing errors on a surgery service at an academic hospital without electronic order entry.
Methods
This was a prospective observational cohort study at a Canadian academic hospital. A medication prescribing curriculum for surgery residents was developed and implemented in July 2019. All general surgery residents (n = 16) at our institution were eligible; 13 (81%) participated. Medication prescribing errors were tracked pre-curriculum implementation (July 1, 2018-June 30, 2019) and post-curriculum (July 1-December 31, 2019). Medication prescribing errors were classified as prescription-writing (PW) or decision-making (DM).
Results
There were 87.5 (14.6) total medication prescribing errors per month in the pre-implementation period with 51.3 (11.9) PW and 36.3 (6.0) DM errors. Post-implementation, there were 78.7 (10.3) total errors monthly with 43.3 (9.5) PW and 35.3 (4.2) DM errors. There were significantly fewer total errors monthly in the first quarter (July–September) of the academic year post-curriculum implementation versus pre-implementation (77.7(12.7) vs. 107.3(8.1); p = 0.035) with significantly fewer PW errors monthly (40.7(13.2) vs. 68.7(9.3); p = 0.046) and no difference in DM errors monthly (37.0(2.0) vs. 38.7(5.7); p = 0.671).
Conclusions
Medication prescribing errors on a surgical service occurred both from prescription-writing and decision-making. Educational interventions, such as our medication prescribing curriculum, can decrease errors related to prescription writing, however the effect appears diminish over time.
Keywords
education, general surgery, inappropriate prescribing, medication errors, residency,
Figure 1
No competing interests reported.
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On 15 Mar, 2021
Reviewer #10 agreed
On 15 Mar, 2021
Reviewer #2 agreed
On 15 Mar, 2021
Reviewer #9 agreed
On 15 Mar, 2021
Reviewer #1 agreed
On 15 Mar, 2021
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This preprint is under consideration at BMC Medical Education. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Boris Zevin
Queen’s University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 19 Mar, 2021
No community comments so far
Review #1 received
Received 22 Mar, 2021
Review #7 received
Received 22 Mar, 2021
Review #6 received
Received 22 Mar, 2021
Review #5 received
Received 22 Mar, 2021
Reviewer #5 agreed
On 15 Mar, 2021
Reviewer #3 agreed
On 15 Mar, 2021
Reviewer #4 agreed
On 15 Mar, 2021
Reviewer #11 agreed
On 15 Mar, 2021
Reviewer #10 agreed
On 15 Mar, 2021
Reviewer #2 agreed
On 15 Mar, 2021
Reviewer #9 agreed
On 15 Mar, 2021
Reviewer #1 agreed
On 15 Mar, 2021
Reviewers invited
Invitations sent on 15 Mar, 2021
Editor assigned
On 15 Mar, 2021
Editor invited
On 15 Mar, 2021
Submission checks complete
On 15 Mar, 2021
First submitted
On 07 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Medication prescribing errors are a source of morbidity and mortality on surgical wards, however educational interventions with proven effectiveness to reduce these errors are lacking. Our objective was to design, implement, and assess the effectiveness of a curriculum designed to reduce medication prescribing errors on a surgery service at an academic hospital without electronic order entry.
Methods
This was a prospective observational cohort study at a Canadian academic hospital. A medication prescribing curriculum for surgery residents was developed and implemented in July 2019. All general surgery residents (n = 16) at our institution were eligible; 13 (81%) participated. Medication prescribing errors were tracked pre-curriculum implementation (July 1, 2018-June 30, 2019) and post-curriculum (July 1-December 31, 2019). Medication prescribing errors were classified as prescription-writing (PW) or decision-making (DM).
Results
There were 87.5 (14.6) total medication prescribing errors per month in the pre-implementation period with 51.3 (11.9) PW and 36.3 (6.0) DM errors. Post-implementation, there were 78.7 (10.3) total errors monthly with 43.3 (9.5) PW and 35.3 (4.2) DM errors. There were significantly fewer total errors monthly in the first quarter (July–September) of the academic year post-curriculum implementation versus pre-implementation (77.7(12.7) vs. 107.3(8.1); p = 0.035) with significantly fewer PW errors monthly (40.7(13.2) vs. 68.7(9.3); p = 0.046) and no difference in DM errors monthly (37.0(2.0) vs. 38.7(5.7); p = 0.671).
Conclusions
Medication prescribing errors on a surgical service occurred both from prescription-writing and decision-making. Educational interventions, such as our medication prescribing curriculum, can decrease errors related to prescription writing, however the effect appears diminish over time.
Figure 1
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