Background Medication systems related to clinical decision support, when implemented in an electronic prescribing program, have the potential to reduce adverse drug reactions.

Purpose To increase safety in the prescription and administration of drugs through the introduction of new warning systems, such as of interactions, maximum doses and a guide to the parenteral administration of drugs, in an electronic prescribing programme (SILICON).

Material and methods 1. The most relevant interactions between the active pharmaceutical ingredients included in the pharmacotherapy guidelines (TFG) were chosen. 2. A search for the maximum dose of the active ingredients present in the parenteral administration TFG was performed. 3. The necessary information was collected in order to create a link between the proper administration and maintenance of the active pharmaceutical ingredients administered parenterally.

Results A total of 70 interaction pairs, corresponding to 16 different active pharmaceutical ingredients, were selected and introduced in SILICON. 100% of the selected interactions were accompanied by a pharmacotherapeutic recommendation.

From a total of 295 active ingredients, 140 maximum doses were considered useful for prescription and validation, and were included in SILICON. In order not to create confusion when prescribing, 28 (9%) files of active ingredients were duplicated in the program to differentiate oral and parenteral maximum doses.

Finally, for the parenteral administration guide, 224 (76%) of active ingredients were selected. Moreover a direct link from the prescription screen to the administration guide was created. All active substances excluded from the guide, have an administration protocol to follow.

All information entered in the prescription program was included on the pharmacy service website.

Conclusion The insertion of maximum dose alerts and interactions, and a link to the updated parenteral drugs administration guide, into an electronic administration program, provides a safety tool. In this way, we contribute towards reducing medication errors.

Reference

1. Rivkin A, Yin H. Evaluation of the role of the critical care pharmacist in identifying and avoiding or minimizing significant drug-drug interactions in medical intensive care patients. J Crit Care 2011;26:104.e1–6

ReferenceNo conflict of interest.