Medication errors in emergency departments: is electronic medical record an effective barrier?

ABSTRACT Objective: To compare medication errors in two emergency departments with electronic medical record, to two departments that had conventional handwritten records at the same organization. Methods: A cross-sectional, retrospective, descriptive, comparative study of medication errors and their classification, according to the National Coordinating Council for Medication Error Reporting and Prevention, associated with the use of electronic and conventional medical records, in emergency departments of the same organization, during one year. Results: There were 88 events per million opportunities in the departments with electronic medical record and 164 events per million opportunities in the units with conventional medical records. There were more medication errors when using conventional medical record – in 9 of 14 categories of the National Coordinating Council for Medication Error Reporting and Prevention. Conclusion: The emergency departments using electronic medical records presented lower levels of medication errors, and contributed to a continuous improvement in patients´ safety.

摘要
目的：对比同一医疗机构内，采用电子病历（electronic medical record）的两个急诊科与采用传统手写病历的另外两个急诊科的用药差错情况。
方法：本研究为横断面、回顾性、描述性对比研究，参照美国国家用药差错报告与预防协调委员会（National Coordinating Council for Medication Error Reporting and Prevention）制定的用药差错分类标准，对同一医疗机构急诊科一年内与电子、传统手写病历相关的用药差错及其分类情况展开分析。
结果：采用电子病历的急诊科每百万次操作机会中发生88起用药差错事件，而采用传统手写病历的科室每百万次操作机会则发生164起用药差错事件。在美国国家用药差错报告与预防协调委员会划定的14类用药差错中，有9类差错在使用传统手写病历时的发生率更高。
结论：采用电子病历的急诊科用药差错水平更低，有助于持续提升患者安全。