A Cerner-based Electronic Prescribing and Medicines Administration (EPMA) Parkinson’s Medicines Care Plan Reduces Time-Critical Medication (TCM) Errors

Introduction:
Parkinson’s UK consistently report that over half of inpatients with Parkinson’s face challenges getting their medications on time. This is associated with patient harm, poorer outcomes and increased admission length. Although electronic prescribing has benefits, it has not solved these issues. We audited local practice and implemented an EPMA care plan to improve reliability.

Method:
A two-cycle clinical audit in a central London teaching hospital. Cycle 1 (n=29) and cycle 2 (n=23) reviewed electronic records over two 4-month periods for inpatients with Parkinson’s disease. Outcomes: prescribing/reconciliation errors, missed/late doses, adverse effects, and use of alternative routes when nil-by-mouth. Multidisciplinary surveys (doctors, nurses, pharmacists) explored perceived causes and confidence/knowledge pre & post. Intervention: a Cerner EPMA Parkinson’s Medicines Care Plan with care-plan–based prescribing, free-text timing at prescribing/administration, 30-minute overdue alerts, and embedded links to local guidance and conversion calculators, supported by targeted teaching.

Results:
Cycle 1: 55% of patients experienced missed/late doses or prescribing errors; 20% had documented clinical deterioration attributable to medication delay/omission. Rotigotine was the commonest alternative route (30%). Surveys identified difficulty prescribing/recording individualised timings and low familiarity with guidance and conversion tools.
Cycle 2: patients with any prescribing/administration issue fell to 34% (21 percentage-point reduction). Prescriber confidence improved (mean 5.2/10 to 6.5/10) and knowledge increased: swallowing-impairment management 46%→91%, correct calculator use 30%→58%, guideline familiarity 23%→58%.

Conclusion:
A co-designed Cerner EPMA Parkinson’s Medicines Care Plan, supported by education, reduced time-critical prescribing/administration problems and improved staff confidence and knowledge. We will share an implementable template via the Parkinson’s UK Excellence Network to support spread across other Cerner sites, alongside work on medication availability and nursing/pharmacy workflows.