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Journal Article > Study
Transcription errors of blood glucose values and insulin errors in an intensive care unit: secondary data analysis toward electronic medical record–glucometer interoperability.
Sowan AK, Vera A, Malshe A, Reed C. JMIR Med Inform. 2019;7:e11873.
This retrospective study examined possible transcription errors for blood glucose values among patients in a surgical intensive care unit for which glucometers did not connect with the electronic health record. Investigators identified multiple insulin dosing errors as a result of transcription errors. They spotlight the need for interoperability between glucometers and electronic health records.
Journal Article > Study
Development and implementation of a subcutaneous insulin pen label bar code scanning protocol to prevent wrong-patient insulin pen errors.
MacMaster HW, Gonzalez S, Maruoka A, et al. Jt Comm J Qual Patient Saf. 2019;45:380-386.
Insulin is a widely used high-risk medication. This quality improvement intervention employed barcode medication administration and a standardized electronic health record–integrated workflow to successfully reduce wrong-patient insulin pen errors. The authors call for widespread implementation of medication safety improvements into electronic health records.
Journal Article > Review
The challenges of electronic health records and diabetes electronic prescribing: implications for safety net care for diverse populations.
Ratanawongsa N, Chan LLS, Fouts MM, Murphy EJ. J Diabetes Res. 2017;2017:8983237.
Diabetes medications are known to be high risk for adverse drug events. This case study reviews several patient safety measures for electronic prescribing for diabetes in outpatient care. Researchers describe an adverse drug event involving electronic prescribing of insulin and detail how the incident could have been prevented. Electronic prescribing is not currently standardized and may require using a trade name for medications, which may lead to prescribing errors. Adoption of the medication naming conventions put forth by the National Library of Medicine's RxNorm would prevent this vulnerability. Similarly, standardizing electronic prescribing orders for high-risk medications like insulin may reduce the risk of erroneously choosing a long-acting instead of short-acting insulin formulation, which can have life-threatening consequences. The authors advocate for using Universal Medication Schedule instructions and providing language-concordant labels to patients to support safe medication self-administration. They suggest that real-time, bidirectional communication between prescribers and pharmacists may improve safe prescribing. The authors conclude that recommended safety practices are not uniformly implemented in clinical practice and advocate for implementation research to ensure medication safety for outpatients with diabetes.