Computerized physician order entry system in pediatric inpatients. Prevention of medication errors and adverse drug events

Pediatric patients are at increased risk for medication errors (ME) because they require weight- and age-adjusted dosing. The aim of this study was to evaluate the rate of ME and potential adverse drug events (ADE) in pediatric inpatients before and after implementation of a computerized physician order entry system (CPOE). Medication errors and potential ADE were evaluated for 14,527 medications (393 patients) before and 18,097 medications (423 patients) after implementation of the CPOE system. Each observation period represented 10 consecutive months. During the observation period before implementation of the CPOE system 484 (3.3%, 117 per 1000 patient days) ME were documented from which 331 (68%) were classified as potential ADE. Of the ADE, 91 (19% of all ME) were classified as serious. After implementation of the CPOE system three incorrect dosages occurred after the physician overruled the warning generated by the system. All other ME were eliminated. Physicians face an unacceptably high rate of ME and ADE in pediatric inpatients. Use of a CPOE system can help improve patient safety and make a contribution to quality management.