title: An Observational Study of the Impact of a Computerized Physician Order Entry System on the Rate of Medication Errors in an Orthopaedic Surgery Unit.
abstract: OBJECTIVE
  To assess the impact of the implementation of a Computerized Physician Order Entry (CPOE) associated with a pharmaceutical checking of medication orders on medication errors in the 3 stages of drug management (i.e. prescription, dispensing and administration) in an orthopaedic surgery unit.
  
  
  METHODS
  A before-after observational study was conducted in the 66-bed orthopaedic surgery unit of a teaching hospital (700 beds) in Paris France. Direct disguised observation was used to detect errors in prescription, dispensing and administration of drugs, before and after the introduction of computerized prescriptions. Compliance between dispensing and administration on the one hand and the medical prescription on the other hand was studied. The frequencies and types of errors in prescribing, dispensing and administration were investigated.
  
  
  RESULTS
  During the pre and post-CPOE period (two days for each period) 111 and 86 patients were observed, respectively, with corresponding 1,593 and 1,388 prescribed drugs. The use of electronic prescribing led to a significant 92% decrease in prescribing errors (479/1593 prescribed drugs (30.1%) vs 33/1388 (2.4%), p < 0.0001) and to a 17.5% significant decrease in administration errors (209/1222 opportunities (17.1%) vs 200/1413 (14.2%), p < 0.05). No significant difference was found in regards to dispensing errors (430/1219 opportunities (35.3%) vs 449/1407 (31.9%), p = 0.07).
  
  
  CONCLUSIONS
  The use of CPOE and a pharmacist checking medication orders in an orthopaedic surgery unit reduced the incidence of medication errors in the prescribing and administration stages. The study results suggest that CPOE is a convenient system for improving the quality and safety of drug management.
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Hernandez
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France.
authors.forename: Elyes
authors.initials: E
authors.lastname: Majoul
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France.
authors.forename: Carlota
authors.initials: C
authors.lastname: Montes-Palacios
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Antignac
authors.affiliation: AP-HP, Saint Antoine Hospital, Orthopaedic Surgery Department, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cherrier
authors.affiliation: AP-HP, Saint Antoine Hospital, Orthopaedic Surgery Department, Paris, France.
authors.forename: Levon
authors.initials: L
authors.lastname: Doursounian
authors.affiliation: AP-HP, Saint Antoine Hospital, Orthopaedic Surgery Department, Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Feron
authors.affiliation: AP-HP, Saint Antoine Hospital, Anaesthetics and Intensive Care Department, Paris, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Robert
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Hejblum
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; Univ Paris-Sud, Faculty of Pharmacy, Chatenay-Malabry, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: AP-HP, Saint Antoine Hospital, Pharmacy Department, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; Univ Paris-Sud, Faculty of Pharmacy, Chatenay-Malabry, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hindlet
mesh_terms: D016303:Clinical Pharmacy Information Systems; D055695:Electronic Prescribing; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000706:statistics & numerical data*; D019637:Orthopedic Procedures; D009985:Orthopedics