目的:本范围审查旨在绘制现有文献,并概述已发表的文章,讨论电子处方对用药错误和药房工作流程的影响。
方法:使用PubMed®进行文献检索,WebofScience®,和Cochrane系统评论数据库®,以及灰色文献报道,使用“药剂师”的搜索词和相关组件,“电子处方”,\"用药错误\",和“效率”。搜索包括2011年1月至2023年9月发表的所有文章。确定并全面审查了22篇相关文章,其中十项纳入本审查。
结果:电子处方(电子处方)为与手写和纸质处方相关的一些挑战提供了解决方案。然而,在所有审查的文章中,电子处方系统的实施被认为是新的不可预见的用药错误的来源。接受电子处方(电子处方)并必须处理由此产生的问题,从而影响了社区药房的生产力。与其他处方形式相比,电子处方并未消除药剂师的干预措施。最常报告的干预原因与使用说明领域的指导不完整有关。电子处方的其他常见挑战与信息缺失有关,数量,不适当的剂量,剂型,和药物。
结论:这篇综述表明,关于电子处方对社区药房用药错误和效率的影响的研究很少。在文学中,大多数研究主要集中在医院药房。文献检索表明,电子处方系统仍有一些障碍需要克服,电子处方并没有完全消除用药错误。电子处方发现了新的错误,所有这些都导致了处理的延迟,这影响了药房工作人员的生产力,如果不能正确解决,可能会对患者的安全产生负面影响。
结论:电子处方解决了一些与手写处方难以辨认相关的挑战。然而,需要更多时间才能使电子处方系统成熟。还建议在实施之前和之后对处方者和药剂师进行进一步培训。
OBJECTIVE: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow.
METHODS: The literature search was conducted using PubMed®, Web of Science®, and the Cochrane Database of Systematic Reviews®, as well as grey literature reports, using the search terms and related components of \"pharmacists\", \"electronic prescribing\", \"medication errors\", and \"efficiency\". The search included all articles that were published from January 2011 to September 2023. Twenty-two relevant articles were identified and fully reviewed, ten of which were included in this review.
RESULTS: Electronic prescribing (e-prescribing) provides a solution for some of the challenges that are associated with handwritten and paper prescriptions. However, the implementation of e-prescribing systems has been recognized as a source of new unforeseen medication errors in all the reviewed articles. Productivity in community pharmacies has been affected with receiving electronic prescriptions (e-prescriptions) and having to deal with the issues that arise from them. The pharmacists\' interventions were not eliminated with e-prescriptions compared to other prescription formats. The most frequently reported reason for intervention was related to incomplete instructions in the field of directions of use. Other common challenges with e-prescriptions were related to missing information, quantity, inappropriate dose, dosage form, and drug.
CONCLUSIONS: This review demonstrates the scarcity of research about the impact of electronic prescribing on medication error and efficiency in community pharmacies. In the literature, most of the studies had mainly focused on hospital pharmacies. The literature search demonstrated that there are still some barriers to overcome with e-prescribing systems and that medication errors were not fully eliminated with e-prescriptions. New errors have been identified with e-prescriptions, all of which caused delays in processing, which affected the productivity of the pharmacy staff, and could have negatively impacted patients\' safety if not properly resolved.
CONCLUSIONS: e-Prescribing solved some of the challenges associated with illegibility of handwritten prescriptions. However, more time is required to allow e-prescribing systems to mature. Further training for prescribers and pharmacists is also recommended before and after the implementation.