title: Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.
abstract: OBJECTIVE
  To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients.
  
  
  METHODS
  We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated.
  
  
  RESULTS
  The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration.
  
  
  CONCLUSIONS
  The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time.
authors.affiliation: University of Wisconsin-Madison, Madison, WI 53706, United States. rcartmill@cqpi.engr.wisc.edu
authors.forename: Randi S
authors.initials: RS
authors.lastname: Cartmill
authors.forename: James M
authors.initials: JM
authors.lastname: Walker
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Blosky
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.forename: Svetolik
authors.initials: S
authors.lastname: Djurkovic
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Dunham
authors.forename: Debra
authors.initials: D
authors.lastname: Gardill
authors.forename: Marilyn T
authors.initials: MT
authors.lastname: Haupt
authors.forename: Dean
authors.initials: D
authors.lastname: Parry
authors.forename: Tosha B
authors.initials: TB
authors.lastname: Wetterneck
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Wood
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017598:Efficiency, Organizational; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D011446:Prospective Studies; D018511:Systems Integration; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents