Difference between revisions of "CPOE in the NICU"

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The rates of variances before and after CPOE implementation were collected and compared
 
The rates of variances before and after CPOE implementation were collected and compared
 
Specific types and reasons for variances also compared
 
Specific types and reasons for variances also compared
 +
 
Results
 
Results
562 medication administrations were observed and documented
+
562 medication administrations were observed and documented
254 medication administration observations pre-CPOE
+
254 medication administration observations pre-CPOE
272 medication administration observations post CPOE
+
272 medication administration observations post CPOE
Rate of variances lower after implementation of CPOE vs. pre-CPOE (11.6% vs 19.8%)
+
Rate of variances lower after implementation of CPOE vs. pre-CPOE (11.6% vs 19.8%)
Note: During rollout period (first month) the variance rate for CPOE was higher than for rest of CPOE period
+
Note: During rollout period (first month) the variance rate for CPOE was higher than for rest of CPOE period
 
74% variances due to: administration mistakes, pharmacy issues, prescribing problems
 
74% variances due to: administration mistakes, pharmacy issues, prescribing problems
 +
 
Conclusion
 
Conclusion
 +
 
The implementation of the Computerized Physician Order System resulted in a decrease in variance between the administration of medications when compared to the medication order. There were still errors associated with the CPOE system.  This suggest that there is still a need to improve the CPOE systems and monitor the related medication errors associated with its ciated with its use. There may be other factors related to medication errors in addition to CPOE.
 
The implementation of the Computerized Physician Order System resulted in a decrease in variance between the administration of medications when compared to the medication order. There were still errors associated with the CPOE system.  This suggest that there is still a need to improve the CPOE systems and monitor the related medication errors associated with its ciated with its use. There may be other factors related to medication errors in addition to CPOE.
 +
 
Related Article
 
Related Article
Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems
+
 
Reference  
+
Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems
 +
 
 +
Reference
 +
 
Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128.
 
Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128.
 
Submitted by Audrey Cobb
 
Submitted by Audrey Cobb
 
[[Category:BMI512-FALL-19]]
 
[[Category:BMI512-FALL-19]]

Revision as of 22:05, 24 October 2019

BMI 512-Clinfowiki Post This is an article review of Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128. Goal The purpose of this study was to evaluate whether or not implementation of a Computerized Physician Order Entry (CPOE) System in the Neonatal Intensive Care Unit (NICU) resulted in a decrease in the medication variance.

Method Summary Prospective observational Study. Research nurses recorded the details of medication administration for NICU patients during a standardized observation period pre- and post-implementation of a CPOE system. The observation period was 3 hours for day, evening and night shifts. The observations occurred on different days of the week. August 2004-June 2005-pre CPOE July 2005-CPOE system installed (Essentris CPOE System): Configured specifically for NICU August 2005-April 2006-post CPOE data collected Details of medication administration compared to details of actual medication order Variance was defined as a discrepancy between the medication order and the administration of the medication The rates of variances before and after CPOE implementation were collected and compared Specific types and reasons for variances also compared

Results 562 medication administrations were observed and documented 254 medication administration observations pre-CPOE 272 medication administration observations post CPOE Rate of variances lower after implementation of CPOE vs. pre-CPOE (11.6% vs 19.8%) Note: During rollout period (first month) the variance rate for CPOE was higher than for rest of CPOE period 74% variances due to: administration mistakes, pharmacy issues, prescribing problems

Conclusion

The implementation of the Computerized Physician Order System resulted in a decrease in variance between the administration of medications when compared to the medication order. There were still errors associated with the CPOE system. This suggest that there is still a need to improve the CPOE systems and monitor the related medication errors associated with its ciated with its use. There may be other factors related to medication errors in addition to CPOE.

Related Article

Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems

Reference

Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128. Submitted by Audrey Cobb