Background and importance In our healthcare district, vaccine electronic prescriptions are not usual. Nurses use immunisation schedules as a prescription and there is no pharmacist validation. The electronic prescription and the pharmacist validation could help us to detect and avoid potential medication errors, improving patient safety.
Aim and objectives To describe the vaccine prescription, validation and dispensation circuit; and to analyse the discrepancies detected after implementation of this procedure.
Material and methods In January 2018, the pharmacy department, in collaboration with the preventive medicine service, developed a procedure for the safe use of vaccines: medical prescription, pharmaceutical validation, dispensing and administration. Vaccine prescription protocols were agreed with the preventive medicine physician and mandatory electronic prescription was established. Since then, the preventive medicine physician prescribes every vaccine through the electronic prescription programme (EPP). The pharmacist validates every prescription: indication, dose and immunisation schedule. If the pharmacist detects any discrepancy, the preventive medicine physician is contacted to resolve it before vaccines are dispensed. Lastly, the nurse administrates the vaccine and registers the batch and expiration date in the electronic medical record, guaranteeing drug traceability.
Results Between July 2019 and September 2020, 1084 vaccines were prescribed and 27 discrepancies were found. 4 of them (14.82%) were justified because the patients needed an accelerated vaccine regimen, but 23 of them (85.18%) were not justified: 3 discrepancies (13.04%) were prescription errors (the wrong vaccine was prescribed), 7 (30.43%) were dosage errors, 8 (34.78%) were errors in the immunisation schedule, in 2 cases (8,66%) no more doses were needed and 3 (13.04%) had a registration error of the last vaccine administration in the electronic medical record. In all cases, a potential medication error was avoided.
Conclusion and relevance Electronic prescription and pharmacist validation allowed us to detect potential medication errors, promoting patient safety in vaccine administration. This circuit is applicable to all hospitals with an EPP and should allow them to detect and prevent potential medication errors.
Conflict of interest No conflict of interest
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