The impact of hospitalwide computerized physician order entry on medical errors in a pediatric hospital.
OBJECTIVE
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.
Upperman
Jeffrey S
JS
Division of Pediatric Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. jeffrey.upperman@chp.edu
Staley
Patricia
P
Friend
Kerri
K
Neches
William
W
Kazimer
David
D
Benes
Jocelyn
J
Wiener
Eugene S
ES
D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D002648:Child; D006776:Hospitals, Pediatric / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D010414:Pennsylvania; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012189:Retrospective Studies