Prevention of potential errors in resuscitation medications orders by means of a computerised physician order entry in paediatric critical care.
BACKGROUND
Computerised physician order entry with clinical decision support system (CPOE+CDSS) is an important tool in attempting to reduce medication errors. The objective of this study was to evaluate the impact of a CPOE+CDSS on (1) the frequency of errors in ordering resuscitation (CPR) medications and (2) the time for printing out the order form, in a paediatric critical care department (PCCD).


METHODS



METHODS
An 18-bed PCCD in a tertiary-care children's hospital.


METHODS
Prospective cohort study.


METHODS
Compilation and comparison of number of errors and time to fill in forms before and after implementation of CPOE+CDSS. Time to fill in conventional, simulated and CPOE forms was measured and compared.


RESULTS
There were three reported incidents of errors among 13,124 CPR medications orders during the year preceding implementation of CPOE+CDSS. These represent errors that escaped the triple check by three independent staff members. There were no errors after CPOE+CDSS was implemented (100% error reduction for 46,970 orders). Time to completion of drug forms dropped from 14 min 42 s to 2 min 14s (p < 0.001).


CONCLUSIONS
CPOE+CDSS completely eliminated errors in filling in the forms and significantly reduced time to completing the form.
Vardi
A
A
The Department of Pediatric Critical Care, Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer Affiliated to The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. avardi@sheba.health.gov.il
Efrati
O
O
Levin
I
I
Matok
I
I
Rubinstein
M
M
Paret
G
G
Barzilay
Z
Z
D016887:Cardiopulmonary Resuscitation; D002648:Child; D020000:Decision Support Systems, Clinical; D006801:Humans; D015278:Intensive Care Units, Pediatric; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014474:Unconsciousness / Q000188:drug therapy*