The effect of Computerized Physician Order Entry and decision support system on medication errors in the neonatal ward: experiences from an Iranian teaching hospital.
Medication dosing errors are frequent in neonatal wards. In an Iranian neonatal ward, a 7.5 months study was designed in three periods to compare the effect of Computerized Physician Order Entry (CPOE) without and with decision support functionalities in reducing non-intercepted medication dosing errors in antibiotics and anticonvulsants. Before intervention (Period 1), error rate was 53%, which did not significantly change after the implementation of CPOE without decision support (Period 2). However, errors were significantly reduced to 34% after that the decision support was added to the CPOE (Period 3; P < 0.001). Dose errors were more often intercepted than frequency errors. Over-dose was the most frequent type of medication errors and curtailed-interval was the least. Transcription errors did not reduce after the CPOE implementation. Physicians ignored alerts when they could not understand why they appeared. A suggestion is to add explanations about these reasons to increase physicians' compliance with the system's recommendations.
Kazemi
Alireza
A
Department of Learning, Informatics, Management and Ethics (LIME), Berzelius Väg 3, Karolinska Institutet, 17177 Stockholm, Sweden. Alireza.kazemi@ki.se
Ellenius
Johan
J
Pourasghar
Faramarz
F
Tofighi
Shahram
S
Salehi
Aref
A
Amanati
Ali
A
Fors
Uno G H
UG
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000927:Anticonvulsants / Q000008:administration & dosage; D016303:Clinical Pharmacy Information Systems; D020000:Decision Support Systems, Clinical; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D007492:Iran; D008297:Male; D050316:Medical Order Entry Systems / Q000592:standards; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital; D009359:Neonatology; D014584:User-Computer Interface
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants