Literature DB >> 15868559

The impact of hospitalwide computerized physician order entry on medical errors in a pediatric hospital.

Jeffrey S Upperman1, Patricia Staley, Kerri Friend, William Neches, David Kazimer, Jocelyn Benes, Eugene S Wiener.   

Abstract

PURPOSE: Medication errors contribute significantly to the morbidity and costs of pediatric health care. The authors hypothesized that hospitalwide computerized physician order entry (CPOE) in a pediatric hospital would lead to a decrease in medication errors.
METHODS: The authors retrospectively evaluated and prospectively analyzed inpatient discharge and usage and adverse drug event (ADE) rate data pre- and postintroduction of a hospitalwide implementation of CPOE in a tertiary care pediatric hospital. They compared pre- and postintervention ADEs (Student's t test) and computed the number needed to treat (NNT) analog.
RESULTS: Over the 9-month study period, there were 45,615 in patient days and 8619 discharges. Pre-CPOE verbal order regulatory compliance was 80%, whereas post-CPOE increased to 95%. Transcription errors were eliminated. All ADEs pre-CPOE were 0.3 +/- 0.04 per 1000 doses, whereas post-CPOE ADEs were 0.37 +/- 0.05 per 1000 doses (P = .3). Harmful ADEs pre-CPOE were 0.05 +/- 0.017 per 1000 doses, while post-CPOE ADEs were 0.03 +/- 0.003 per 1000 doses (P = .05). Our NNT data demonstrate that CPOE would prevent 1 ADE every 64 (95% CI 25-100) patient days.
CONCLUSIONS: CPOE decreases harmful ADEs in a pediatric hospital, thus leading to increased patient safety. In addition, CPOE provides an automated system for monitoring and improving health care quality.

Entities:  

Mesh:

Year:  2005        PMID: 15868559     DOI: 10.1016/j.jpedsurg.2004.09.024

Source DB:  PubMed          Journal:  J Pediatr Surg        ISSN: 0022-3468            Impact factor:   2.545


  30 in total

1.  Impact of vendor computerized physician order entry in community hospitals.

Authors:  Alexander A Leung; Carol Keohane; Mary Amato; Steven R Simon; Michael Coffey; Nathan Kaufman; Bismarck Cadet; Gordon Schiff; Eyal Zimlichman; Diane L Seger; Catherine Yoon; Peter Song; David W Bates
Journal:  J Gen Intern Med       Date:  2012-01-21       Impact factor: 5.128

Review 2.  Medication errors in paediatric care: a systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations.

Authors:  Marlene R Miller; Karen A Robinson; Lisa H Lubomski; Michael L Rinke; Peter J Pronovost
Journal:  Qual Saf Health Care       Date:  2007-04

Review 3.  The effect of electronic prescribing on medication errors and adverse drug events: a systematic review.

Authors:  Elske Ammenwerth; Petra Schnell-Inderst; Christof Machan; Uwe Siebert
Journal:  J Am Med Inform Assoc       Date:  2008-06-25       Impact factor: 4.497

Review 4.  The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: a systematic review.

Authors:  Jesse I Wolfstadt; Jerry H Gurwitz; Terry S Field; Monica Lee; Sunila Kalkar; Wei Wu; Paula A Rochon
Journal:  J Gen Intern Med       Date:  2008-04       Impact factor: 5.128

5.  The Triangle Model for evaluating the effect of health information technology on healthcare quality and safety.

Authors:  Jessica S Ancker; Lisa M Kern; Erika Abramson; Rainu Kaushal
Journal:  J Am Med Inform Assoc       Date:  2011-08-20       Impact factor: 4.497

Review 6.  Computerized clinical decision support for medication prescribing and utilization in pediatrics.

Authors:  Jeremy S Stultz; Milap C Nahata
Journal:  J Am Med Inform Assoc       Date:  2012-07-19       Impact factor: 4.497

7.  Using an Evidence-Based Approach to EMR Implementation to Optimize Outcomes and Avoid Unintended Consequences.

Authors:  Christopher A Longhurst; Jonathan P Palma; Lisa M Grisim; Eric Widen; Melanie Chan; Paul J Sharek
Journal:  J Healthc Inf Manag       Date:  2013

8.  The influence that electronic prescribing has on medication errors and preventable adverse drug events: an interrupted time-series study.

Authors:  Jasperien E van Doormaal; Patricia M L A van den Bemt; Rianne J Zaal; Antoine C G Egberts; Bertil W Lenderink; Jos G W Kosterink; Flora M Haaijer-Ruskamp; Peter G M Mol
Journal:  J Am Med Inform Assoc       Date:  2009-08-28       Impact factor: 4.497

Review 9.  Just what the doctor ordered. Review of the evidence of the impact of computerized physician order entry system on medication errors.

Authors:  Tatyana A Shamliyan; Sue Duval; Jing Du; Robert L Kane
Journal:  Health Serv Res       Date:  2008-02       Impact factor: 3.402

Review 10.  Interventions to reduce dosing errors in children: a systematic review of the literature.

Authors:  Sharon Conroy; Dimah Sweis; Claire Planner; Vincent Yeung; Jacqueline Collier; Linda Haines; Ian C K Wong
Journal:  Drug Saf       Date:  2007       Impact factor: 5.606

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