In the News: Residents May Need More Oversight to Avoid eRx Errors

Wednesday, May 1, 2019

A recent retrospective cohort study published in the Southern Medical Journal examined electronic medication orders placed by medical residents in academic teaching hospitals. It concluded that, despite the benefits of encouraging autonomy, residents would benefit from more supervision, pharmacy support, and opportunities for consultation when it comes to making EHR medication orders. This is particularly true when it comes to making dosing adjustments for renal impairment.

The study was summarized in the Pharmacy Times article, “Study Lays Bare Residents’ E-Medication Prescribing Errors.”

Ultimately, researchers found that pharmacists were able to identify errors in around 4% of medication orders entered by residents. As all of these were caught, they were corrected, thus averting potential patient harms.

Renal impairment appeared to present a notable challenge to residents, contributing to 40% of all errors reported. Failing to account for appropriate dose adjustments led to 69% of errors with antimicrobials and 65% of errors with anticoagulants. Overall, these were the two drug classes associated with the highest error rates.

Other notable findings centered around timing and training:

  • Errors were least frequent in July – when new residencies begin and supervision is heightened
  • Errors were highest in August
  • Errors peak in the morning, possibly due to volume of orders and multitasking
  • Not surprisingly, errors were highest in the first year of residency, PGY 1
  • PGY 3 residents made MORE errors than PGY 2, which researchers thought might be related to the higher-level residents having more autonomy, engaging in fewer consultations with attending staff, and handling more complex cases

To learn more, read the complete article.

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