Impact of computerized physician order entry on medication errors

被引:11
|
作者
Menendez, M. D. [1 ]
Alonso, J. [2 ]
Rancano, I. [1 ]
Corte, J. J. [3 ]
Herranz, V. [4 ]
Vazquez, F. [1 ,5 ]
机构
[1] Hosp Monte Naranco, Unidad Calidad & Gest Riesgo Clin, Oviedo, Spain
[2] Hosp Monte Naranco, Gest Presupuestaria, Oviedo, Spain
[3] Hosp Monte Naranco, Serv Farm, Oviedo, Spain
[4] Hosp Monte Naranco, Gerencia, Oviedo, Spain
[5] Fac Med, Area Microbiol, Dept Biol Func, Oviedo, Spain
关键词
Medication errors; Computerized provider order entry systems;
D O I
10.1016/j.cali.2012.01.010
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Information is scarce on the impact of the clinical electronic record on the frequency and severity of medication errors in acute geriatric patients. Material and methods: An analytical and descriptive pre-post study was conducted on the implementation of computerized provider order entry systems (CPOE), over a 6 year period. A voluntary reporting system was used to detect the medication errors using the IR2 report form of the UK National Health Service, the Global Trigger Tool and the walk rounds with the Pharmacy Service. The severity categories were taken from the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Index Categorizing Errors. Results: A total of 1887 medication errors (1553 patients) were detected in the period of study, and represented the first adverse event reported (29.3%). 8.5 adverse events per 100 admissions were found (0.24 in the categories E through I) and the prescription errors represented a 27.6%. By drugs dispensed, adverse events were 2.07 times more frequent in the 3 year period (2007-2009) with electronic clinical record than in the 3 year period with the hand-written system (2004-2006), being more frequent with antibiotics (1.92 times), antipyretic (2.21 times) and opiates (2.72 times). For serious errors and by doses dispensed, there were 5.18 times less frequent serious errors in the period related to the electronic record, drug omission (46.8 times less frequent), wrong dose (10.53 times) and antibiotics (10.84 times). Conclusion: Frequent medication errors were found in acute geriatric patients. An increase in medication errors and a decline in the severity of the detected errors were found in relationship to the electronic clinical record. For these reasons, the implementation of the electronic clinical record should be monitored. (C) 2011 SECA. Published by Elsevier Espana, S.L. All rights reserved.
引用
收藏
页码:334 / 340
页数:7
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