Literature DB >> 17142590

Effect of computerisation on the quality and safety of chemotherapy prescription.

Marc Voeffray1, André Pannatier, Roger Stupp, Nadia Fucina, Serge Leyvraz, Jean-Blaise Wasserfallen.   

Abstract

BACKGROUND: Chemotherapy is prescribed according to protocols of several cycles. These protocols include not only therapeutic agents but also adjuvant solvents and inherent supportive care measures. Multiple errors can occur during the prescription, the transmission of documents and the drug delivery processes, and lead to potentially serious consequences.
OBJECTIVE: To assess the effect of a computerised physician order entry (CPOE) system on the number of errors in prescription recorded by the centralised chemotherapy unit of a pharmacy service in a university hospital. PATIENTS AND METHODS: Existing chemotherapy protocols were standardised by a multidisciplinary team (composed of a doctor, a pharmacist and a nurse) and a CPOE system was developed from a File Maker Pro database. Chemotherapy protocols were progressively introduced into the CPOE system. The effect of the system on prescribing errors was measured over 15 months before and 21 months after starting computerised protocol prescription. Errors were classified as major (dosage and drug name) and minor (volume or type of infusion solution).
RESULTS: Before computerisation, 141 errors were recorded for 940 prescribed chemotherapy regimens (15%). After introduction of the CPOE system, 75 errors were recorded for 1505 prescribed chemotherapy regimens (5%). Of these errors, 69 (92%) were recorded in prescriptions that did not use a computerised protocol. A dramatic decrease in the number of errors was noticeable when 50% of the chemotherapy protocols were prescribed through the CPOE system.
CONCLUSION: Errors in chemotherapy prescription nearly disappeared after implementation of CPOE. The safety of chemotherapy prescription was markedly improved.

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Year:  2006        PMID: 17142590      PMCID: PMC2464896          DOI: 10.1136/qshc.2005.016808

Source DB:  PubMed          Journal:  Qual Saf Health Care        ISSN: 1475-3898


  21 in total

1.  Effects of computerized physician order entry on prescribing practices.

Authors:  J M Teich; P R Merchia; J L Schmiz; G J Kuperman; C D Spurr; D W Bates
Journal:  Arch Intern Med       Date:  2000-10-09

2.  The safety of computer-based medication systems.

Authors:  Mark Graber
Journal:  Arch Intern Med       Date:  2004-02-09

3.  Computerized physician order entry: helpful or harmful?

Authors:  Robert G Berger; J P Kichak
Journal:  J Am Med Inform Assoc       Date:  2003-11-21       Impact factor: 4.497

Review 4.  Effects of computerized physician order entry and clinical decision support systems on medication safety: a systematic review.

Authors:  Rainu Kaushal; Kaveh G Shojania; David W Bates
Journal:  Arch Intern Med       Date:  2003-06-23

5.  Computer physician order entry: benefits, costs, and issues.

Authors:  Gilad J Kuperman; Richard F Gibson
Journal:  Ann Intern Med       Date:  2003-07-01       Impact factor: 25.391

6.  Error reduction in pediatric chemotherapy: computerized order entry and failure modes and effects analysis.

Authors:  George R Kim; Allen R Chen; Robert J Arceci; Sandra H Mitchell; K Michelle Kokoszka; Denise Daniel; Christoph U Lehmann
Journal:  Arch Pediatr Adolesc Med       Date:  2006-05

Review 7.  A model of methods for influencing prescribing: Part II. A review of educational methods, theories of human inference, and delineation of the model.

Authors:  D W Raisch
Journal:  DICP       Date:  1990-05

8.  Medication prescribing errors in a teaching hospital.

Authors:  T S Lesar; L L Briceland; K Delcoure; J C Parmalee; V Masta-Gornic; H Pohl
Journal:  JAMA       Date:  1990-05-02       Impact factor: 56.272

9.  Physicians' decisions to override computerized drug alerts in primary care.

Authors:  Saul N Weingart; Maria Toth; Daniel Z Sands; Mark D Aronson; Roger B Davis; Russell S Phillips
Journal:  Arch Intern Med       Date:  2003-11-24

10.  Computerized physician order entry and medication errors in a pediatric critical care unit.

Authors:  Amy L Potts; Frederick E Barr; David F Gregory; Lorianne Wright; Neal R Patel
Journal:  Pediatrics       Date:  2004-01       Impact factor: 7.124

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  31 in total

1.  Applying HFMEA to prevent chemotherapy errors.

Authors:  Chia-Hui Cheng; Chia-Jen Chou; Pa-Chun Wang; Hsi-Yen Lin; Chi-Lan Kao; Chao-Ton Su
Journal:  J Med Syst       Date:  2010-11-11       Impact factor: 4.460

2.  Safe Implementation of Computerized Provider Order Entry for Adult Oncology.

Authors:  D B Martin; D Kaemingk; D Frieze; P Hendrie; T H Payne
Journal:  Appl Clin Inform       Date:  2015-10-28       Impact factor: 2.342

3.  Survey of oral chemotherapy safety and adherence practices of hospitals in Spain.

Authors:  David Conde-Estévez; Esther Salas; Joan Albanell
Journal:  Int J Clin Pharm       Date:  2013-10-16

Review 4.  Does computerized provider order entry reduce prescribing errors for hospital inpatients? A systematic review.

Authors:  Margaret H Reckmann; Johanna I Westbrook; Yvonne Koh; Connie Lo; Richard O Day
Journal:  J Am Med Inform Assoc       Date:  2009-06-30       Impact factor: 4.497

5.  Impact of a computerized physician order entry system on compliance with prescription accuracy requirements.

Authors:  Caroline Mir; Amina Gadri; Georges L Zelger; Renaud Pichon; André Pannatier
Journal:  Pharm World Sci       Date:  2009-06-25

6.  Toward successful migration to computerized physician order entry for chemotherapy.

Authors:  J Jeon; S Taneva; V Kukreti; P Trbovich; A C Easty; P G Rossos; J A Cafazzo
Journal:  Curr Oncol       Date:  2014-04       Impact factor: 3.677

7.  Principles of Safe Practice Using an Oncology EHR System for Chemotherapy Ordering, Preparation, and Administration, Part 1 of 2.

Authors:  Lawrence N Shulman; Robert S Miller; Edward P Ambinder; Peter Paul Yu; John V Cox
Journal:  J Oncol Pract       Date:  2008-07       Impact factor: 3.840

8.  Implementation of safeguards to improve patient safety in chemotherapy.

Authors:  M J Huertas-Fernández; Mª J Martínez-Bautista; M E Rodríguez-Mateos; M Zarzuela-Ramírez; T Muñoz-Lucero; J M Baena-Cañada
Journal:  Clin Transl Oncol       Date:  2017-03-30       Impact factor: 3.405

9.  Clinical and economic impact of pharmacists' intervention in a large volume chemotherapy preparation unit.

Authors:  Ji-Min Han; Young-Mi Ah; Sung Yun Suh; Sun-Hoi Jung; Hyeon Joo Hahn; Seock-Ah Im; Ju-Yeun Lee
Journal:  Int J Clin Pharm       Date:  2016-06-30

Review 10.  Computerized prescriber order entry in the outpatient oncology setting: from evidence to meaningful use.

Authors:  V Kukreti; R Cosby; A Cheung; S Lankshear
Journal:  Curr Oncol       Date:  2014-08       Impact factor: 3.677

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