Article

Potential benefits and problems with computerized prescriber order entry: Analysis of a voluntary medication error-reporting database

University of Maryland, Baltimore, Baltimore, Maryland, United States
American Journal of Health-System Pharmacy (Impact Factor: 2.21). 03/2006; 63(4):353-8. DOI: 10.2146/ajhp050379
Source: PubMed

ABSTRACT The potential benefits and problems associated with computerized prescriber-order-entry (CPOE) systems were studied.
A national voluntary medication error-reporting database, Medmarx, was used to compare facilities that had CPOE with those that did not have CPOE. The characteristics of medication errors reportedly caused by CPOE were explored, and the text descriptions of these errors were qualitatively analyzed.
Facilities with CPOE reported fewer inpatient medication errors and more outpatient medication errors than facilities without CPOE, but the statistical significance of these differences could not be determined. Facilities with CPOE less frequently reported medication errors that reached patients (p < 0.01) or harmed patients (p < 0.01). More than 7000 CPOE-related medication errors were reported over seven months in 2003, and about 0.1% of them resulted in harm or adverse events. The most common CPOE errors were dosing errors (i.e., wrong dose, wrong dosage form, or extra dose). Both quantitative and qualitative analyses indicate that CPOE could lead to medication errors not only because of faulty computer interface, mis-communication with other systems, and lack of adequate decision support but also because of common human errors such as knowledge deficit, distractions, inexperience, and typing errors.
A national, voluntary medication error-reporting database cannot be used to determine the effectiveness of a CPOE system in reducing medication errors because of the variability in the number of reports from different institutions. However, it may provide valuable information on the specific types of errors related to CPOE systems.

0 Followers
 · 
127 Views
  • Source
    • "Frameworks to classify the problem, process and outcome of medication error reports are summarised in Tables 1–3 respectively. Introduction of electronic MMS that incorporate computerised physician order entry (CPOE) into a hospital inpatient setting is reported to reduce the incidence of serious medication error (Kaushal et al. 2003, Ash et al. 2004, Roach et al. 2004, Zhan et al. 2006). Reported benefits of MMS and CPOE include simplified prescription, selection and administration processes (Nolen & Rodes 2008), elimination of common communication and documentation errors attributed to incomplete, ambiguous or illegible hand-written medication orders (Seeley et al. 2004, Kuperman et al. 2007) and a decreased rate of non-intercepted serious medication errors (Bates et al. 1998, Kaushal et al. 2003). "
  • Source
    • "Frameworks to classify the problem, process and outcome of medication error reports are summarised in Tables 1–3 respectively. Introduction of electronic MMS that incorporate computerised physician order entry (CPOE) into a hospital inpatient setting is reported to reduce the incidence of serious medication error (Kaushal et al. 2003, Ash et al. 2004, Roach et al. 2004, Zhan et al. 2006). Reported benefits of MMS and CPOE include simplified prescription, selection and administration processes (Nolen & Rodes 2008), elimination of common communication and documentation errors attributed to incomplete, ambiguous or illegible hand-written medication orders (Seeley et al. 2004, Kuperman et al. 2007) and a decreased rate of non-intercepted serious medication errors (Bates et al. 1998, Kaushal et al. 2003). "
  • Source
    • "Frameworks to classify the problem, process and outcome of medication error reports are summarised in Tables 1–3 respectively. Introduction of electronic MMS that incorporate computerised physician order entry (CPOE) into a hospital inpatient setting is reported to reduce the incidence of serious medication error (Kaushal et al. 2003, Ash et al. 2004, Roach et al. 2004, Zhan et al. 2006). Reported benefits of MMS and CPOE include simplified prescription, selection and administration processes (Nolen & Rodes 2008), elimination of common communication and documentation errors attributed to incomplete, ambiguous or illegible hand-written medication orders (Seeley et al. 2004, Kuperman et al. 2007) and a decreased rate of non-intercepted serious medication errors (Bates et al. 1998, Kaushal et al. 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Aims and objectives. To explore the effects of introducing an electronic medication management system on reported medica-tion errors. Background. Computerised medication management systems have been found to improve medication safety; however, intro-ducing medication management system into healthcare environments can create unanticipated or new problems and oppor-tunities for medication error. Design. Descriptive analysis of medication error reports. Methods. This was a retrospective analysis of 359 incident reports drawn from the period of 1 May 2005–30 April 2006 across two hospital sites of a single not-for-profit private health service located in metropolitan Melbourne. Site A used a conventional pen and paper system for medication management, and Site B had introduced a computerised medication management system. Results. Most medication errors occurred at the nurse administration (71Á5%) and prescribing (16Á4%) stages of delivery. The most common medication error type reported at Site A was omission (33%), and at Site B was wrong documentation (24Á2%). A higher proportion of errors at the prescribing phase, and less nurse administration errors, were detected at Site B where the medication management system was in use. The incidence of other, less frequent errors was similar across the two hospital sites. Conclusions. This examination of medication error reports suggests there are differences in the types of medication errors that are reported in association with the introduction of electronic medication management system compared to pen and paper system systems. The findings provide a new insight into the effects of introducing an electronic medication manage-ment system on the types of medication errors reported. Relevance to clinical practice. The findings provide a new insight into the types of medication errors that are reported dur-ing implementation of an electronic medication management system. Extra support for physicians prescribing practices should be considered.
    Journal of Clinical Nursing 06/2012; 22(3). DOI:10.1111/j.1365-2702.2012.04326.x · 1.23 Impact Factor
Show more