Saudi Cultural Missions Theses & Dissertations
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Item Restricted Investigating The Effect of Updating Warfarin Care Plan on The Rate of Dose Omission(2023) Halawani, Sarah; Wright, PaulObjectives: Clinical decision support (CDS) systems are part of the electronic prescribing strategies aimed at enhancing patient safety, especially with high-alert medications such as warfarin. The aim of this study is to evaluate the effect of updating the warfarin care plan, a type of CDS, on the omission error rate of warfarin. In addition, to assess its effects on patient safety and the quality of service. Methods: A retrospective pre and post-service evaluation was conducted at a specialised hospital in the UK. All patients on warfarin over six months (June 2022 to December 2022) were included in this evaluation. Data were analysed with a focus on incidence rates, and types of warfarin missed doses. Results: Pre and post-care plan update groups comprised 92 and 82 patients, respectively. A 2% significant reduction in the total warfarin missed doses rate, from 9.15% in the pre-intervention group to 6.53% post-intervention, was reported (P-value 0.011). Conclusion: As part of the CDS, the updated care plan significantly reduced the rates of warfarin missed doses pre and post-intervention, further supporting the use of electronic prescribing strategies to enhance patient safety.8 0Item Restricted The difference in the incidence of 126 high-risk prescribing errors pre- and post-EPMA implementation using iMPACT tool(2022) Halawani, Sarah; Garfield, Sarah; Onatade, RaliatBackground: A prescribing error (PE) is defined as any unintentional significant reduction in the probability of treatment being timely and effective or an increase in the risk of harm due to a prescribing decision. The number of medication errors in the UK in 2019 was estimated at 237 million. PEs accounted for 21%. The Investigating Medication Prescribing Accuracy for Critical Error Types (iMPACT) tool provides a standardised way of collecting and defining PEs. iMPACT uses 126 pre-defined high-risk prescribing error indicators (PEIs). They were chosen by the iMPACT team. PEIs were based on the severity of different PEs in various clinical scenarios. This study contributes to adding evidence to the existing literature about PE rates in the UK. Methods: A prospective pre and post-quasi-study at Bart’s Health NHS Trust using the iMPACT tool over a 2–3-week period pre-and post-EPMA. Error rate, error type, the most common medicines associated with errors, and the clinical decision were identified and analyzed. Results: There was a significant difference in the total prescribing error rates between pre- and post-EPMA with a p-vlaue<0.001. Prescribing error rates were significantly reduced in five of the indicators pre-and post-implementation comparison. The most common type of error post-EPMA was seen in drug interaction. Conclusion: This study's findings could help optimize the patients’ care in the future. Most of the indicators had a lower error rate post-EPMA; however, some of them had a higher rate even if it was not significant.15 0