Effectiveness of ‘do not disturb’ strategies in reducing errors during discharge prescription writing

Abstract

Background Prescribing errors not only impose safety risks, but also delay hospital discharges and adversely affect patient satisfaction. The effect of reducing environmental interruptions on prescribing errors has not been published previously. Aim The aim of this study was to determine the combined effect of two ‘do not disturb’ (DND) strategies in decreasing the average number of prescribing errors by reducing distractions during discharge prescription writing. A secondary aim was to assess the effect of the interventions on prescription correction time. Methods In all, 392 discharge prescriptions from two general medical wards of a teaching hospital were audited over a 10‐week period in a prospective interventional before‐and‐after audit. Clinical pharmacists collected data on the number and type of errors, and time taken to correct errors. DND vests and workstations were made available during the intervention phase. Junior medical officers (JMO) provided daily feedback to the nurse unit managers (NUM) on the number and source of distractions, as well as the use of DND vests and workstations after the intervention. Results The percentage of error‐free discharge prescriptions increased from 29.7% before to 51.5% after the intervention (p < 0.0001). The mean number of errors per prescription decreased from 1.7 to 1.1 (p < 0.01) in both wards combined. The median time taken to correct erroneous prescriptions did not change significantly. Feedback provided by JMOs showed a marked reduction in interruptions, with 73% stating they were not interrupted at all or just once during prescribing after the intervention, compared with 17% before the intervention. Conclusion DND strategies decreased the rate of erroneous prescriptions.