Effects of Computerized Alerts on the Use of Unapproved Medication Abbreviations by Medical Interns

1University of Pennsylvania, Philadelphia, PA
2University of Pennsylvania, Philadelphia, PA
3University of Pennsylvania, Philadelphia, PA
4University of Pennsylvania, Philadelphia, PA
5University of Pennsylvania, Philadelphia, PA
6University of Pennsylvania, Philadelphia, PA
7University of Pennsylvania, Philadelphia, PA

Meeting: Hospital Medicine 2008, April 3-5, San Diego, Calif.

Abstract number: 55

Background:

Medication abbreviation errors account for a substantial proportion of total medication errors. National regulatory organizations have prohibited the use of certain commonly misinterpreted medication abbreviations in an effort to improve patient safety, yet physician compliance with this regulation has been poor. Educational interventions directed at physicians in training may be more successful in reducing unapproved abbreviation use because documentation patterns are just beginning to form in this population.

Methods:

A randomized controlled study was conducted at a university hospital where interns use a computer program to create patient sign‐outs and daily notes. Fifty‐nine internal medicine interns were randomized to 1 of 3 treatment groups: a control group with no exposure to computerized alerts for abbreviations (CTRL), a group exposed to a computerized alert that forced corrections for unapproved abbreviations (STOP), and a group exposed to a computerized alert that identified the unapproved abbreviations and automatically corrected them (AUTO). A repeated‐measures design was performed to record the number of handwritten medication abbreviation errors compared to the total opportunities for such error in the written admission notes of the interns before and after the intervention. A computerized tracking system counted alerts for the 2 groups exposed to treatment conditions. Differences among the groups were assessed using logistic regression and chi‐square analyses.

Results:

Interns in all 3 groups reduced their use of handwritten unapproved abbreviations over time (P < 01). Interns in the STOP group had a greater reduction in the number of written unapproved abbreviations in their documentation compared with both CTRL (p = .02) and AUTO (P < .01) groups. The number of written unapproved abbreviations in the AUTO group was not significantly different from than that of the CTRL group (P = .34). The number of alerts in the computerized notes decreased over time in both the STOP and AUTO groups, with slightly more reductions in the STOP group (P = .06).

Conclusions:

Computerized alerts designed to force the correction of unapproved abbreviations can reduce abbreviation use in the computer and handwritten documentation of medical trainees. Alerts designed to educate trainees about unapproved abbreviations through an educational auto‐correction feature did not reduce the frequency of unapproved abbreviations in their handwritten documentation.

Author Disclosure:

J. Myers, none; S. Gojraty, none; A. Linsky, none; S. Airan‐Javia, none; S. Kratowicz, none; F. Wan, none; R. Polomano, none.

To cite this abstract:

Myers J, Gojraty S, Linsky A, Airan‐Javia S, Kratowicz S, Wan F, Polomano R. Effects of Computerized Alerts on the Use of Unapproved Medication Abbreviations by Medical Interns. Abstract published at Hospital Medicine 2008, April 3-5, San Diego, Calif. Abstract 55. Journal of Hospital Medicine. 2008; 3 (suppl 1). https://www.shmabstracts.com/abstract/effects-of-computerized-alerts-on-the-use-of-unapproved-medication-abbreviations-by-medical-interns/. Accessed May 26, 2019.

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