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Preprinted Prescription Forms Decrease Incomplete Handwritten Medication Prescriptions in a Neonatal Intensive Care Unit

Hogden, Laurie A. MD; Low, Jeffrey K. PharmD; Knoerlein, Kimberly D. ARNP; Edwards, William H. MD

Original Article
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Objectives: A preprinted prescription order form was developed as a quality improvement project in our neonatal intensive care unit to increase compliance with established medication order writing guidelines.

Methods: A preprinted form was designed to guide prescribers through the process of handwriting a complete inpatient prescription by using forcing functions. Approximately 60% of prescribed medications were included on a single page, with blank fields only for the order components that were variable. Standard dose recommendations were printed on the reverse side of the form. To assess the effectiveness of this intervention, medication prescriptions were collected for two weeks before and after introduction of the new forms and evaluated for compliance with medication prescription guidelines. The prescriptions were analyzed for the presence of order date/time, patient weight, medication/dose, route, reference dose and printed name or pager number of the prescriber.

Results: Inclusion of time of prescription increased from 86% to 99%, patient weight from 57% to 98%, weight based dose from 37% to 91% route of administration from 89% to 98% and printed name or pager from 70% to 99% (P > 0.01 for route of administration, P > 0.01 for others).

Conclusions: The introduction of preprinted medication order forms in a neonatal intensive care unit significantly improved compliance with medication prescription guidelines.

From *Neonatal Resources of Wisconsin, Inc., Madison, Wisconsin, and †Children's Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Correspondence: Laurie A. Hogden, MD, Neonatal Resources of Wisconsin, Inc., 707 South Mills St., Madison, Wisconsin 53715 (e-mail: Laurie_Hogden_md@ssmhc.com).

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