The Effect of a Computerized Prescribing and Calculating System on Hypo‐ and Hyperglycemias and on Prescribing Time Efficiency in Neonatal Intensive Care Patients

Maat, Barbara; Rademaker, Carin M. A.; Oostveen, Marloes I.; Krediet, Tannette G.; Egberts, Toine C. G.; Bollen, Casper W.

doi:10.1177/0148607112444608

Cited by 23 publications

(48 citation statements)

References 42 publications

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“…44 Notably, Maat and colleagues identified no reduction in medication errors associated with their implementation of CDS to assist in managing hypo/hyperglycaemia, but they did observe reductions in time taken to perform simple (1.3; 0.3-2.3 min) or complex orders (8.6; 5.1-12.1 min). 49 The potential for altered intervention effectiveness due to local variable factors is raised by Abboud and colleagues, who identified no reduction in gentamicin monitoring errors following the introduction of CDS as part of the prescribing process. 41 In this case, the authors suggested that the intervention had minimal benefit because they already had a clinical pharmacist responsible for ensuring monitoring was performed correctly, but results could differ in settings where clinical pharmacists are not present.…”

Section: Discussionmentioning

confidence: 99%

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Interventions to reduce medication errors in neonatal care: a systematic review

Nguyen

Mosel

Grzeskowiak

2017

Therapeutic Advances in Drug Safety

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Background: Medication errors represent a significant but often preventable cause of morbidity and mortality in neonates. The objective of this systematic review was to determine the effectiveness of interventions to reduce neonatal medication errors. Methods: A systematic review was undertaken of all comparative and noncomparative studies published in any language, identified from searches of PubMed and EMBASE and referencelist checking. Eligible studies were those investigating the impact of any medication safety interventions aimed at reducing medication errors in neonates in the hospital setting. Results: A total of 102 studies were identified that met the inclusion criteria, including 86 comparative and 16 noncomparative studies. Medication safety interventions were classified into six themes: technology (n = 38; e.g. electronic prescribing), organizational (n = 16; e.g. guidelines, policies, and procedures), personnel (n = 13; e.g. staff education), pharmacy (n = 9; e.g. clinical pharmacy service), hazard and risk analysis (n = 8; e.g. error detection tools), and multifactorial (n = 18; e.g. any combination of previous interventions). Significant variability was evident across all included studies, with differences in intervention strategies, trial methods, types of medication errors evaluated, and how medication errors were identified and evaluated. Most studies demonstrated an appreciable risk of bias. The vast majority of studies (>90%) demonstrated a reduction in medication errors. A similar median reduction of 50-70% in medication errors was evident across studies included within each of the identified themes, but findings varied considerably from a 16% increase in medication errors to a 100% reduction in medication errors. Conclusion: While neonatal medication errors can be reduced through multiple interventions aimed at improving the medication use process, no single intervention appeared clearly superior. Further research is required to evaluate the relative cost-effectiveness of the various medication safety interventions to facilitate decisions regarding uptake and implementation into clinical practice.

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Section: Discussionmentioning

confidence: 99%

“…Electronic medication prescribing and atuomated dose checking [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] Computerized physician order entry (n = 5)…”

Section: Intervention Type Example Of Intervention Referencesmentioning

confidence: 99%

Interventions to reduce medication errors in neonatal care: a systematic review

Nguyen

Mosel

Grzeskowiak

2017

Therapeutic Advances in Drug Safety

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“…Dutch clinical pharmacy focuses on individual patient treatment—for instance, by developing automated CDS and rules tailored to specific patients 19 20…”

Section: Introductionmentioning

confidence: 99%

Clinical pharmacy interventions in paediatric electronic prescriptions

Maat

Bollen

et al. 2012

Archives of Disease in Childhood

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Paediatric prescribing errors occur frequently and are not completely prevented by electronic prescribing systems. This study provides information for improvements in electronic prescribing for paediatric patients. Incorporating tailored solutions, such as minimised free-text entry, certain obligatory fields and integrated dose checking and indications, can improve the quality and efficiency of electronic prescribing in paediatrics.

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“…However, there are studies indicating positive effects of CPOE systems. For example, in a study by Maat et al, the findings indicated a positive impact of the CPOE system on saving time when prescribing (30). Similarly, Balina et al and Hoonakker et al also showed that the use of CPOE systems led to saving prescription time (14, 2).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription

et al. 2018

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BackgroundThe field of medicine has been influenced by the growth and development of information systems such as the Computerized Provider Order Entry (CPOE) System.ObjectiveThis study aimed to evaluate the usability of CPOE systems for electronic prescription in Tehran, Iran.MethodsThis was an evaluation study conducted in 2017. The research population consisted of the CPOE systems used in hospitals of Tehran (Iran) and nurses who had access to, and used, the CPOE systems. Five hospitals with CPOE systems were included in the research sample. The data were collected using a questionnaire, and included a total of 50 questions. The questionnaires were distributed among 254 nurses who were the users of the systems. Data analysis was performed by IBM-SPSS version 21, using independent-samples t-test. A p-value of ≤0.05 was considered statistically significant.ResultsAmong the four aspects assessed, the “user-friendliness” (3.87±0.59) had the highest mean score. The lowest mean score (2.01±0.58) was related to the “decision support” feature of the systems. The highest and lowest mean scores for “prescription support” criterion belonged to system E (3.26±0.23) and system C (1.90±0.16), respectively. There was a statistically significant difference between the usability of the systems used in the private and the public hospitals (p<0.001). It was found that the CPOE systems in private hospitals had a higher level of usability (3.42+0.10) compared to those in public hospitals (2.91+0.25).ConclusionTwo main functions of the studied CPOE systems i.e., decision support and prescription support should be developed to make electronic prescription safer and more intuitive. Addressing usability aspects of CPOE systems in practice could improve the usability of these systems for prescription.

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The Effect of a Computerized Prescribing and Calculating System on Hypo‐ and Hyperglycemias and on Prescribing Time Efficiency in Neonatal Intensive Care Patients

Abstract: CPOE including a special CDS tool preserved accuracy for calculation and control of glucose intake and increased prescribing time efficiency.

Cited by 23 publications

References 42 publications

Interventions to reduce medication errors in neonatal care: a systematic review

Interventions to reduce medication errors in neonatal care: a systematic review

Clinical pharmacy interventions in paediatric electronic prescriptions

Evaluation of computerized provider order entry systems: assessing the usability of systems for electronic prescription

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