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PSNet: Patient Safety Network
Web Resource
Government Resource

Investigation into Electronic Prescribing and Medicines Administration Systems and Safe Discharge.

Investigation into Electronic Prescribing and Medicines Administration Systems and Safe Discharge. Healthcare Safety Investigation Branch. Farnborough, UK: 2019.

Design flaws and improper use of technologies that transfer medication and prescription information between provider environments is a known threat to patient safety. This report analyzes an anticoagulant overdose incident and found that information technology missteps contributed to the error.