Our clinic staff can use Epic web to enter prescriptions, and transmit
them to the pharmacy if they choose. (Epic web markets medical record
systems.)
Yesterday I was called upon to dispense the following:
SF 5000 PLUS 1.1 % DT CREA
Qty: 2 tubes Ref: 6
Start: 5/20/2004 End:
Route: Dental
Sig: use as directed on hand rash
The prescription was from an experienced member of our staff. I'd never
heard of using SF 5000 on a hand rash, and two colleagues were similarly
surprised.
I opted to page the physician, who professed ignorance of the
prescription, suggesting perhaps a resident wrote it. I said it seemed
to bear a signature that looked like the doctor's name. The doctor did
recall seeing the patient for dry hands or something, asked me to change
it to 2.5% HC cream, and thanked me.
I find it notable that one of our technicians entered the prescription
without noticing the error, someone else ordered two tubes of SF Plus,
and still another affixed the labels, before I finally detected the
mistake.
However, my point is that electronic prescribing may eliminate many
problems, but it is not foolproof.
Toothpaste Pete
rxempress - 23 May 2004 14:12 GMT
I agree. I am finding mistakes on rxs entered via palm pilots several times
a month. Usually it is the wrong drug. Yesterday one came in prescribing
some sort of otc combo cough med (something like guaifen 100-2-5) It was
written generically and I could not figure out what the doctor wanted.(like
what the 2-5 meant) I called the doctor and found out that she had entered
the wrong drug.... she wanted Robitussin AC.
Other errors are abbreviations such as CPCR. What? It means controlled
release capsule.
wc - 23 May 2004 19:03 GMT
> I find it notable that one of our technicians entered the prescription
> without noticing the error, someone else ordered two tubes of SF Plus,
[quoted text clipped - 5 lines]
>
> Toothpaste Pete
How about eliminating technicians . . . particularly dumb ones.
Sam - 28 May 2004 22:09 GMT
"I find it notable that one of our technicians entered the prescription
without noticing the error, someone else ordered two tubes of SF Plus,
and still another affixed the labels, before I finally detected the
mistake."
I don't think technicians have the knowledge to pick up such mistakes.
dogwoman8@webtv.net - 29 May 2004 23:49 GMT
I am becoming more and more wary of "high tech" solutions. The scripts
mentioned in the previous thread on the large sheets of paper are being
typed up by the nurses in the clinic near our pharmacy. That is ok, and
they are signed by the doctor. But the errors that are coming thru in
names of drugs, strengths, quantities, and directions are getting scary.
We may just have to be that much more careful with the electronic
gadgets, than we were before.
Using the computer systems can give a false sense of security. We had a
situation that the wrong doctor was chosen from a listing at the central
support. This was not caught until sometime later as the first scripts
were call in and everyone thought everything was correct until a written
script came thru and could do a clear comparison of DEA numbers. I have
told all techs do not rely on the central, if it is a new doctor, put in
the information provided on the script. Now if the techs would only
listen instead of thinking they know better. (To any pharmacy
technicians on this group, I am not making a blanket statement. I am
just in a situation that I have no say in who is hired and/or trained to
be a tech and this is causing some real problems where I work)
Even the comparing of drug interactions is again a false sense of
security. I have found that the soft wear is not necessarily noting
these and when fingers are flying to a script out every 1 to 2 minutes,
things are not being noted.
I would be interested in how others go about checking things on the
computer where techs are putting scripts in without standing staring
over their shoulder, or going thru and doing it all over again yourself.
A very tired pharmacist