title: Impact of computerized physician order entry on medication errors.
abstract: BACKGROUND
  Information is scarce on the impact of the clinical electronic record on the frequency and severity of medication errors in acute geriatric patients.
  
  
  METHODS
  An analytical and descriptive pre-post study was conducted on the implementation of computerized provider order entry systems (CPOE), over a 6 year period. A voluntary reporting system was used to detect the medication errors using the IR2 report form of the UK National Health Service, the Global Trigger Tool and the walk rounds with the Pharmacy Service. The severity categories were taken from the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index Categorizing Errors.
  
  
  RESULTS
  A total of 1887 medication errors (1553 patients) were detected in the period of study, and represented the first adverse event reported (29.3%). 8.5 adverse events per 100 admissions were found (0.24 in the categories E through I) and the prescription errors represented a 27.6%. By drugs dispensed, adverse events were 2.07 times more frequent in the 3 year period (2007-2009) with electronic clinical record than in the 3 year period with the hand-written system (2004-2006), being more frequent with antibiotics (1.92 times), antipyretic (2.21 times) and opiates (2.72 times). For serious errors and by doses dispensed, there were 5.18 times less frequent serious errors in the period related to the electronic record, drug omission (46.8 times less frequent), wrong dose (10.53 times) and antibiotics (10.84 times).
  
  
  CONCLUSIONS
  Frequent medication errors were found in acute geriatric patients. An increase in medication errors and a decline in the severity of the detected errors were found in relationship to the electronic clinical record. For these reasons, the implementation of the electronic clinical record should be monitored.
authors.affiliation: Unidad Calidad y Gestión del Riesgo Clínico, Hospital Monte Naranco, Oviedo, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Menendez
authors.forename: J
authors.initials: J
authors.lastname: Alonso
authors.forename: I
authors.initials: I
authors.lastname: Rancaño
authors.forename: J J
authors.initials: JJ
authors.lastname: Corte
authors.forename: V
authors.initials: V
authors.lastname: Herranz
authors.forename: F
authors.initials: F
authors.lastname: Vazquez
mesh_terms: D005069:Evaluation Studies as Topic; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000706:statistics & numerical data*