Difference between revisions of "CPOE in the NICU"
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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. | 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 | + | |
| + | 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. | 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 | 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. | + | |
| − | + | 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 tion 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 | 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 | 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 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 | ||
| − | + | ||
| − | 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]] | ||
| + | [[Category:Reviews]] | ||
Latest revision as of 02:32, 25 October 2019
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 tion 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
