National assessment of the feasibility and satisfaction of e-prescribing programmes in critical care units.

Abstract

Introduction: Intensive Care Units (ICU) are recognized as high-risk settings for medication errors, primarily due to the complex pharmacological regimens and the critical condition of patients. It is estimated that the probability of errors occurring in these units is two to three times higher than in general hospital patients, with prescribing and administration being the stages most frequently associated with such incidents.

Objective: To evaluate the applicability and satisfaction with electronic prescribing systems in Intensive Care Units of hospitals in Spain.

Methods: A nationwide survey was conducted targeting pharmacists to assess the functionalities of the electronic prescribing systems used in these units. The evaluation covered hospital characteristics, features of the prescribing software, and healthcare professionals' satisfaction, with the aim of understanding the current situation and proposing improvement strategies to enhance medication safety through prescribing systems in the context of critically ill patients.

Results: A total of 64 surveys were completed across 55 different hospitals. In 50.8% of cases, a prescribing system different from that used in general hospital wards was employed. In 84.4% of cases, the system had been developed by a commercial vendor. In 65.1% of hospitals, the system enabled communication with the pharmacy, and in 57.7% it allowed for pharmaceutical validation. However, 50.8% of the systems were not capable of interfacing with automated dispensing or administration systems. In 71.9% of cases, the system allowed for direct data extraction. Pharmacists reported satisfactory overall perceptions in only 43.8% of cases, while 42.9% identified unmet needs requiring improvement.

Conclusions: Despite significant heterogeneity in the functionalities of electronic prescribing systems across Spanish ICUs, such systems are widely implemented nationwide and are regarded as a key element in ensuring medication safety within these units. Clinical pharmacists reported a generally acceptable level of satisfaction; however, there remains considerable scope for improvement.