Difference between revisions of "CPOE in the NICU"

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This is an article review of Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128.
 
This is an article review of Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128.
Goal  
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 +
Goal
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The purpose of this study was to evaluate whether or not implementation of a Computerized Physician Order Entry (CPOE) System in the Neonatal Intensive Care Unit (NICU) resulted in a decrease in the medication variance.
 
The purpose of this study was to evaluate whether or not implementation of a Computerized Physician Order Entry (CPOE) System in the Neonatal Intensive Care Unit (NICU) resulted in a decrease in the medication variance.
  
 
Method Summary
 
Method Summary
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Prospective observational Study. Research nurses recorded the details of medication administration for NICU patients during a standardized observation period pre- and post-implementation of a CPOE system. The observation period was 3 hours for day, evening and night shifts. The observations occurred on different days of the week.
 
Prospective observational Study. Research nurses recorded the details of medication administration for NICU patients during a standardized observation period pre- and post-implementation of a CPOE system. The observation period was 3 hours for day, evening and night shifts. The observations occurred on different days of the week.
 
August 2004-June 2005-pre CPOE
 
August 2004-June 2005-pre CPOE
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Results
 
Results
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562 medication administrations were observed and documented
 
562 medication administrations were observed and documented
 
254 medication administration observations pre-CPOE
 
254 medication administration observations pre-CPOE

Revision as of 22:10, 24 October 2019

This is an article review of Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128.

Goal

The purpose of this study was to evaluate whether or not implementation of a Computerized Physician Order Entry (CPOE) System in the Neonatal Intensive Care Unit (NICU) resulted in a decrease in the medication variance.

Method Summary

Prospective observational Study. Research nurses recorded the details of medication administration for NICU patients during a standardized observation period pre- and post-implementation of a CPOE system. The observation period was 3 hours for day, evening and night shifts. The observations occurred on different days of the week. August 2004-June 2005-pre CPOE July 2005-CPOE system installed (Essentris CPOE System): Configured specifically for NICU August 2005-April 2006-post CPOE data collected Details of medication administration compared to details of actual medication order Variance was defined as a discrepancy between the medication order and the administration of the medication The rates of variances before and after CPOE implementation were collected and compared Specific types and reasons for variances also compared

Results

562 medication administrations were observed and documented 254 medication administration observations pre-CPOE 272 medication administration observations post CPOE Rate of variances lower after implementation of CPOE vs. pre-CPOE (11.6% vs 19.8%) Note: During rollout period (first month) the variance rate for CPOE was higher than for rest of CPOE period 74% variances due to: administration mistakes, pharmacy issues, prescribing problems

Conclusion

The implementation of the Computerized Physician Order System resulted in a decrease in variance between the administration of medications when compared to the medication order. There were still errors associated with the CPOE system. This suggest that there is still a need to improve the CPOE systems and monitor the related medication errors associated with its ciated with its use. There may be other factors related to medication errors in addition to CPOE.

Related Article

Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems

Reference

Taylor, J. A., Loan, A.L., Kamara, J., Blackburn, S. and Whitney, D. (2008). Medication Administration Variances Before and After implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. Pediatrics, 121(1), 123-128. Submitted by Audrey Cobb