title: We thought we would be perfect: medication errors before and after the initiation of Computerized Physician Order Entry.
abstract: BACKGROUND
  Because the Institute of Medicine demanded health care improvement, electronic medical records have been implemented with the hopes of eliminating iatrogenic injury caused by avoidable mistakes. Electronic orders and electronic medical records survived its initial slow adoption and have since had a myriad of identifiable flaws as it becomes incorporated nationally.
  
  
  METHODS
  This retrospective study at a university teaching hospital analyzed all medication order errors (OEs) for the 26 wk of paper-order entries before computer physician order entry (CPOE) and 26 weeks after CPOE was initiated. All OEs were included and documented by month as well as severity using standard taxonomy.
  
  
  RESULTS
  Results indicated that CPOE yielded a significant increase in overall medication OE with five of six severity categories remaining the same or increasing in OE. Severity categories A and E saw a significant increase once CPOE began (P < 0.01). Pre-CPOE OEs were 1741, whereas Post-CPOE OEs were 2226, showing an increase in overall medication errors (P < 0.01). After CPOE began, the cumulative successive errors recorded were 112, 290, 267, 307, 412, 399, and 439 with an R(2) value of 0.849 and a P value of 0.003 in the analysis of variance to test regression relation.
  
  
  CONCLUSIONS
  As CPOE adapts for its real-world applications, it may eventually prove useful in reducing errors; however, perfection and error free order entry will not be achieved unless objective data analysis guides its evolution.
authors.affiliation: Department of Surgery, Monmouth Medical Center, Long Branch, New Jersey.
authors.forename: David
authors.initials: D
authors.lastname: Schwartzberg
authors.affiliation: St. George's University, School of Medicine, St. George's, Grenada.
authors.forename: Sasa
authors.initials: S
authors.lastname: Ivanovic
authors.affiliation: Department of Surgery, Newark Beth Israel Medical Center and Children's Hospital of New Jersey, Newark, New Jersey.
authors.forename: Sheetal
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Surgery, Newark Beth Israel Medical Center and Children's Hospital of New Jersey, Newark, New Jersey. Electronic address: sathyabc@yahoo.com.
authors.forename: Sathyaprasad C
authors.initials: SC
authors.lastname: Burjonrappa
mesh_terms: D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors; D012189:Retrospective Studies
keywords: Computer physician order entry; Medication error; University hospital