Abstract：
BACKGROUND: This project is part of a broader effort to develop a new electronic registry for ophthalmology in the KwaZulu-Natal (KZN) province in South Africa. The registry should include a clinical decision support system that reduces the potential for human error and should be applicable for our diversity of hospitals, whether electronic health record (EHR) or paper-based.
METHODS: Post-operative prescriptions of consecutive cataract surgery discharges were included for 2019 and 2020. Comparisons were facilitated by the four chosen state hospitals in KZN each having a different system for prescribing medications: Electronic, tick sheet, ink stamp and handwritten health records. Error types were compared to hospital systems to identify easily-correctable errors. Potential error remedies were sought by a four-step process.
RESULTS: There were 1307 individual errors in 1661 prescriptions, categorised into 20 error types. Increasing levels of technology did not decrease error rates but did decrease the variety of error types. High technology scripts had the most errors but when easily correctable errors were removed, EHRs had the lowest error rates and handwritten the highest.
CONCLUSIONS: Increasing technology, by itself, does not seem to reduce prescription error. Technology does, however, seem to decrease the variability of potential error types, which make many of the errors simpler to correct.Contribution: Regular audits are an effective tool to greatly reduce prescription errors, and the higher the technology level, the more effective these audit interventions become. This advantage can be transferred to paper-based notes by utilising a hybrid electronic registry to print the formal medical record.
METHODS: Post-operative prescriptions of consecutive cataract surgery discharges were included for 2019 and 2020. Comparisons were facilitated by the four chosen state hospitals in KZN each having a different system for prescribing medications: Electronic, tick sheet, ink stamp and handwritten health records. Error types were compared to hospital systems to identify easily-correctable errors. Potential error remedies were sought by a four-step process.
RESULTS: There were 1307 individual errors in 1661 prescriptions, categorised into 20 error types. Increasing levels of technology did not decrease error rates but did decrease the variety of error types. High technology scripts had the most errors but when easily correctable errors were removed, EHRs had the lowest error rates and handwritten the highest.
CONCLUSIONS: Increasing technology, by itself, does not seem to reduce prescription error. Technology does, however, seem to decrease the variability of potential error types, which make many of the errors simpler to correct.Contribution: Regular audits are an effective tool to greatly reduce prescription errors, and the higher the technology level, the more effective these audit interventions become. This advantage can be transferred to paper-based notes by utilising a hybrid electronic registry to print the formal medical record.
摘要：
背景：该项目是在南非夸祖鲁-纳塔尔省（KZN）开发新的眼科电子注册表的更广泛努力的一部分。注册应包括一个临床决策支持系统，以减少人为错误的可能性，并应适用于我们多元化的医院，无论是电子健康记录(EHR)还是纸质记录。
方法：纳入2019年和2020年连续白内障手术出院的术后处方。KZN的四家选定的州立医院促进了比较，每家医院都有不同的处方药物系统：电子，打勾表,墨水印章和手写的健康记录。将错误类型与医院系统进行比较，以识别易于纠正的错误。通过四步过程寻求潜在的错误补救措施。
结果：1661个处方中有1307个错误，分为20种错误类型。技术水平的提高并没有降低错误率，但确实减少了错误类型的种类。高科技脚本的错误最多，但是当删除易于纠正的错误时，EHR的错误率最低，手写的错误率最高。
结论：不断增加的技术，本身,似乎没有减少处方错误。技术确实如此，然而,似乎减少了潜在错误类型的可变性，这使得许多错误更容易纠正。贡献：定期审核是大大减少处方错误的有效工具，技术水平越高，这些审计干预措施越有效。通过使用混合电子注册表来打印正式的医疗记录，可以将此优点转移到纸质笔记上。
方法：纳入2019年和2020年连续白内障手术出院的术后处方。KZN的四家选定的州立医院促进了比较，每家医院都有不同的处方药物系统：电子，打勾表,墨水印章和手写的健康记录。将错误类型与医院系统进行比较，以识别易于纠正的错误。通过四步过程寻求潜在的错误补救措施。
结果：1661个处方中有1307个错误，分为20种错误类型。技术水平的提高并没有降低错误率，但确实减少了错误类型的种类。高科技脚本的错误最多，但是当删除易于纠正的错误时，EHR的错误率最低，手写的错误率最高。
结论：不断增加的技术，本身,似乎没有减少处方错误。技术确实如此，然而,似乎减少了潜在错误类型的可变性，这使得许多错误更容易纠正。贡献：定期审核是大大减少处方错误的有效工具，技术水平越高，这些审计干预措施越有效。通过使用混合电子注册表来打印正式的医疗记录，可以将此优点转移到纸质笔记上。
