がん化学療法における処方チェックシステムの確立 : 1次・2次チェックシステムの導入による処方の安全性向上

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We have introduced a computerized prescription checking system for cancer chemotherapy that helps ensure medical safety. In developing it, we incorporated a regimen ordering function into the electronic medical record system (EMRS) and registered chemotherapy regimens for which prescriptions could be ordered, restricting orders for antitumor drugs from physicians to those in the regimens. All registered regimens were reviewed and approved by an in-hospital pharmacotherapy committee. Under the primary check system, doses of antitumor drugs are automatically calculated based on patient body weight or body surface area. The limit on the highest dose of each antitumor drug is 110% of the automatically calculated dose. When ordering chemotherapy regimens, doses of antitumor drugs are ordered without converting to the number of vials of each size. In the pharmacy subsystem, orders are sent to the pharmacy and totals made of all prescriptions. Then, doses of antitumor drugs are automatically converted into the number of each size of vial based on cost performance and the numbers of vials is printed on prescriptions to support dispensing. The system also makes chemotherapy administration records to help ensure that doses of antitumor drugs for each patient are reasonable. The introduction of our system has made chemotherapy dosage errors much less likely and the total prescription error rate was reduced to 0.15% (0.10% for outpatient chemotherapy, 0.21% for inpatient chemotherapy). It has also greatly reduced pharmacists' workload in prescription checking. We feel that our prescription checking system has decreased the chemotherapy prescription error rate for the errors that were most likely to harm patients.
日本医療薬学会の論文
2008-10-10

がん化学療法における処方チェックシステムの確立 : 1次・2次チェックシステムの導入による処方の安全性向上

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