Abstract：
BACKGROUND: With hospital electronic prescribing and medicines administration (HEPMA) systems now in widespread use across hospital inpatient clinical services, work is underway to measure the benefits of HEPMA on healthcare systems and patient care. HEPMA functionality enables users to prescribe medicines by \'bundle\' or \'protocol\'. Although it is assumed that this is a significant system benefit, there are few qualitative studies supporting this conclusion.
OBJECTIVE: To explore the impact of an electronic anticipatory care medicines protocol on junior doctor perceptions of their confidence and competence to prescribe opioids and midazolam for patients at the end of life.
METHODS: Between May and August 2022, one-to-one semi-structured interviews were conducted at a 570-bed District General Hospital with junior doctors who had experience of prescribing on both HEPMA and paper-based systems. Audio recordings of the interviews were transcribed verbatim and underwent thematic analysis.
RESULTS: Ten junior doctors participated (median age 23 years). Analysis generated five main themes that described perceptions and attitudes towards confidence and competence. These were prescribing safety benefits; information technology infrastructure, interoperability and system design concerns; clinical knowledge and training needs; cultural and social factors and risks of automation in prescribing.
CONCLUSIONS: This study suggests that junior doctors experienced an overall increase in their confidence and perceived competence to prescribe anticipatory medicines post-implementation of a HEPMA protocol. Further studies are required to detail the impact of HEPMA/CPOE protocols on clinical practice.
OBJECTIVE: To explore the impact of an electronic anticipatory care medicines protocol on junior doctor perceptions of their confidence and competence to prescribe opioids and midazolam for patients at the end of life.
METHODS: Between May and August 2022, one-to-one semi-structured interviews were conducted at a 570-bed District General Hospital with junior doctors who had experience of prescribing on both HEPMA and paper-based systems. Audio recordings of the interviews were transcribed verbatim and underwent thematic analysis.
RESULTS: Ten junior doctors participated (median age 23 years). Analysis generated five main themes that described perceptions and attitudes towards confidence and competence. These were prescribing safety benefits; information technology infrastructure, interoperability and system design concerns; clinical knowledge and training needs; cultural and social factors and risks of automation in prescribing.
CONCLUSIONS: This study suggests that junior doctors experienced an overall increase in their confidence and perceived competence to prescribe anticipatory medicines post-implementation of a HEPMA protocol. Further studies are required to detail the impact of HEPMA/CPOE protocols on clinical practice.
摘要：
背景：随着医院电子处方和药品管理（HEPMA）系统现已在医院住院临床服务中广泛使用，正在进行工作，以衡量HEPMA对医疗保健系统和患者护理的好处。HEPMA功能使用户能够通过“捆绑”或“协议”开药。尽管假设这是一个重大的系统好处，很少有定性研究支持这一结论。
目的：探讨电子预期治疗药物方案对初级医生对其在生命末期为患者开阿片类药物和咪达唑仑的信心和能力的看法的影响。
方法：在2022年5月至8月之间，在拥有570张床位的地区综合医院与初级医生进行了一对一的半结构化访谈，这些初级医生在HEPMA和纸质系统上都有处方经验。访谈的录音被逐字转录，并进行了主题分析。
结果：10名初级医生参加（中位年龄23岁）。分析产生了五个主要主题，描述了对信心和能力的看法和态度。这些规定了安全利益；信息技术基础设施，互操作性和系统设计问题；临床知识和培训需求；文化和社会因素以及处方自动化的风险。
结论：这项研究表明，在实施HEPMA方案后，初级医生对处方预期药物的信心和感知能力总体上有所提高。需要进一步的研究来详细说明HEPMA/CPOE方案对临床实践的影响。
目的：探讨电子预期治疗药物方案对初级医生对其在生命末期为患者开阿片类药物和咪达唑仑的信心和能力的看法的影响。
方法：在2022年5月至8月之间，在拥有570张床位的地区综合医院与初级医生进行了一对一的半结构化访谈，这些初级医生在HEPMA和纸质系统上都有处方经验。访谈的录音被逐字转录，并进行了主题分析。
结果：10名初级医生参加（中位年龄23岁）。分析产生了五个主要主题，描述了对信心和能力的看法和态度。这些规定了安全利益；信息技术基础设施，互操作性和系统设计问题；临床知识和培训需求；文化和社会因素以及处方自动化的风险。
结论：这项研究表明，在实施HEPMA方案后，初级医生对处方预期药物的信心和感知能力总体上有所提高。需要进一步的研究来详细说明HEPMA/CPOE方案对临床实践的影响。
