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https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#1
Thomas G Kannampallil, Joanna Abraham, Anna Solotskaya, Sneha G Philip, Bruce L Lambert, Gordon D Schiff, Adam Wright, William L Galanter
Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors. Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006-2011; n  = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28336760/analysis-of-variations-in-the-display-of-drug-names-in-computerized-prescriber-order-entry-systems
#2
Arbor J L Quist, Thu-Trang T Hickman, Mary G Amato, Lynn A Volk, Alejandra Salazar, Alexandra Robertson, Adam Wright, David W Bates, Shobha Phansalkar, Bruce L Lambert, Gordon D Schiff
PURPOSE: The variations in how drug names are displayed in computerized prescriber-order-entry (CPOE) systems were analyzed to determine their contribution to potential medication errors. METHODS: A diverse set of 10 inpatient and outpatient CPOE system vendors and self-developed CPOE systems in 6 U.S. healthcare institutions was evaluated. A team of pharmacists, physicians, patient-safety experts, and informatics experts created a CPOE assessment tool to standardize the assessment of CPOE features across the systems studied...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28219462/the-use-of-a-computerized-provider-order-entry-alert-to-decrease-rates-of-clostridium-difficile-testing-in-young-pediatric-patients
#3
Maribeth R Nicholson, Peter N Freswick, M Cecilia Di Pentima, Li Wang, Kathryn M Edwards, Gregory J Wilson, Thomas R Talbot
BACKGROUND Infants and young children are frequently colonized with C. difficile but rarely have symptomatic disease. However, C. difficile testing remains prevalent in this age group. OBJECTIVE To design a computerized provider order entry (CPOE) alert to decrease testing for C. difficile in young children and infants. DESIGN An interventional age-targeted before-after trial with comparison group SETTING Monroe Carell Jr. Children's Hospital at Vanderbilt University, Nashville, Tennessee. PATIENTS All children seen in the inpatient or emergency room settings from July 2012 through July 2013 (pre-CPOE alert) and September 2013 through September 2014 (post-CPOE alert) INTERVENTION In August of 2013, we implemented a CPOE alert advising against testing in infants and young children based on the American Academy of Pediatrics recommendations with an optional override...
February 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28186069/the-impact-of-computerized-provider-order-entry-on-nursing-practice
#4
Rosabella Vito, Elizabeth M Borycki, Andre W Kushniruk, Tracey Schneider
Health information systems, such as Computerized Provider Order Entry (CPOE), are suggested to be used as an intervention for addressing errors that arise in the medication process. Nurses are involved in all stages of the medication process; however, little is known about the impact of using CPOE on nursing practice. A grounded theory approach was employed to answer the question of "How do nurses perceive the impact of CPOE on the medication process and collaborative practice?" Ten participants were interviewed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28186021/considering-the-language-of-computerized-order-entry-systems
#5
Simon Diemert, Jens Weber, Morgan Price
Computerized Provider Order Entry (CPOE) systems have been shown to introduce new problems into clinical environments. Given the communication intensive nature of these systems considering the language(s) of communication can provide insight into their function and subsequent problems. The current (as November 2015) CPOE literature was reviewed using the language concepts of syntax, semantics, and pragmatics as a lens. In total, 202 articles were considered, of these only 46 received a full review. 145 results related to language concepts were extracted from these articles...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28152814/standardization-of-oral-chemotherapy-delivery-to-improve-patient-safety-a-pilot-study
#6
Maritza Carvalho, Ron Fung, Devi Ahuja, Simerjit Gollee, Bernadette Almeida, Gurpreet Grewal, Katherine Enright
90 Background: Oral chemotherapy (OC) presents unique challenges to patient safety. In contrast with parenteral chemotherapy, patient education and comprehension are crucial to the safe administration of OC, appropriate toxicity interventions and patient adherence. At Trillium Health Partners we identified a lack of standardization to OC education and monitoring, that resulted in gaps in patient care. Using the American Society of Clinical Oncology/Oncology Nursing Society 2013 chemotherapy safety standards as guidance, we developed and piloted a multi-disciplinary oral chemotherapy care pathway (OCCP) to improve the approach to education and monitoring of patients newly started on OC...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152695/improving-anti-emetics-in-chemotherapy-induced-nausea-and-vomiting
#7
Ron Fung, Katherine Enright
220 Background: Chemotherapy induced nausea and vomiting (CINV) remains one of the most feared treatment-related toxicities in cancer patients. CINV has been shown to decrease quality of life and to increase dose modifications and unplanned hospital visits. Cancer Care Ontario (CCO) and the American Society of Clinical Oncology (ASCO) updated their CINV guidelines in 2013. These changes included a reclassification of many regimens from moderate (MEC) to highly emetogenic (HEC) and a decrease in the duration of serotonin inhibitors (5HT3i)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152681/bringing-provincial-improvements-to-oral-chemotherapy-prescribing-through-co-ordinated-regional-initiatives
#8
Noor Ahmad, Leonard Kaizer, Erin Redwood, Kathy Vu, Colleen Fox, Elaine Meertens, Monika K Krzyzanowska
107 Background: Oral chemotherapy delivery is complex, making safe medication practices a high priority. Cancer Care Ontario, the provincial government agency responsible for continually improving cancer services in Ontario, undertook a jurisdiction-wide quality improvement initiative to ensure that all oral chemotherapy drugs are prescribed using Computerized Prescriber Order Entry (CPOE) or standardized Pre-printed Orders (PPO). The initiative was further enabled by changes to the provincial funding approach that flows facility funding for oral chemotherapy delivery...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28078665/computerized-pharmacy-surveillance-and-alert-system-for-drug-related-problems
#9
O Ferrández, O Urbina, S Grau, J Mateu-de-Antonio, M Marin-Casino, J Portabella, S Mojal, M Riu, E Salas
WHAT IS KNOWN AND OBJECTIVE: Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment...
April 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28063462/going-digital-a-narrative-overview-of-the-clinical-and-organisational-impacts-of-ehealth-technologies-in-hospital-practice
#10
Justin Keasberry, Ian A Scott, Clair Sullivan, Andrew Staib, Richard Ashby
Objective The aim of the present study was to determine the effects of hospital-based eHealth technologies on quality, safety and efficiency of care and clinical outcomes.Methods Systematic reviews and reviews of systematic reviews of eHealth technologies published in PubMed/Medline/Cochrane Library between January 2010 and October 2015 were evaluated. Reviews of implementation issues, non-hospital settings or remote care or patient-focused technologies were excluded from analysis. Methodological quality was assessed using a validated appraisal tool...
January 9, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28000358/a-feasibility-study-for-a-clinical-decision-support-system-prompting-hiv-testing
#11
D R Chadwick, C Hall, C Rae, Ml Rayment, M Branch, J Littlewood, A Sullivan
OBJECTIVES: Levels of undiagnosed HIV infection and late presentation remain high globally despite attempts to increase testing. The objective of this study was to evaluate a risk-based prototype application to prompt HIV testing when patients undergo routine blood tests. METHODS: Two computer physician order entry (CPOE) systems were modified using the application to prompt health care workers (HCWs) to add an HIV test when other tests selected suggested that the patient was at higher risk of HIV infection...
December 21, 2016: HIV Medicine
https://www.readbyqxmd.com/read/27999841/a-novel-survey-to-examine-the-relationship-between-health-it-adoption-and-nurse-physician-communication
#12
A Jay Holmgren, Eric Pfeifer, Milisa Manojlovich, Julia Adler-Milstein
BACKGROUND: As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use. OBJECTIVES: To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption...
December 21, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27995044/a-concise-drug-alerting-rule-set-for-chinese-hospitals-and-its-application-in-computerized-physician-order-entry-cpoe
#13
Yinsheng Zhang, Xin Long, Weihong Chen, Haomin Li, Huilong Duan, Qian Shang
BACKGROUND: A minimized and concise drug alerting rule set can be effective in reducing alert fatigue. OBJECTIVES: This study aims to develop and evaluate a concise drug alerting rule set for Chinese hospitals. The rule set covers not only western medicine, but also Chinese patent medicine that is widely used in Chinese hospitals. SETTING: A 2600-bed general hospital in China. METHODS: In order to implement the drug rule set in clinical information settings, an information model for drug rules was designed and a rule authoring tool was developed accordingly...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27919372/does-extended-cpoe-use-reduce-patient-length-of-stay
#14
Darryl Romanow, Arun Rai, Mark Keil, Steven Luxenberg
OBJECTIVE: This study compares use of Computerized Provider Order Entry (CPOE) and related clinical systems (i.e., extended CPOE) across 796 clinical teams caring for five distinct patient conditions. Our focus is the relationship between clinical teams' extended CPOE use and extent of prolonged stay (EPS), defined as the deviation in patients' observed length of stay from expected risk-adjusted length of stay. MATERIALS AND METHODS: Using archival data from two affiliated hospitals in the Southeastern United States, we focused on five different patient conditions of varying mortality risk (vaginal birth, knee/hip replacement, cardiovascular surgery, organ transplant and pneumonia)...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27830247/computerized-clinical-decision-support-contributions-from-2015
#15
V Koutkias, J Bouaud
OBJECTIVE: To summarize recent research and select the best papers published in 2015 in the field of computerized clinical decision support for the Decision Support section of the IMIA yearbook. METHOD: A literature review was performed by searching two bibliographic databases for papers related to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. The aim was to identify a list of candidate best papers from the retrieved papers that were then peer-reviewed by external reviewers...
November 10, 2016: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/27785159/effects-of-a-computerized-provider-order-entry-and-a-clinical-decision-support-system-to-improve-cefazolin-use-in-surgical-prophylaxis-a-cost-saving-analysis
#16
Lucas M Okumura, Izelandia Veroneze, Celia I Burgardt, Marta F Fragoso
BACKGROUND: Computerized Provider Order Entry (CPOE) and Clinical Decision Support System (CDSS) help practitioners to choose evidence-based decisions, regarding patients' needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. OBJECTIVE: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing...
July 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/27757179/factors-influencing-the-adoption-of-health-information-technologies-a-systematic-review
#17
Ali Garavand, Mohammah Mohseni, Heshmatollah Asadi, Manal Etemadi, Mohammad Moradi-Joo, Ahmad Moosavi
INTRODUCTION: The successful implementation of health information technologies requires investigating the factors affecting the acceptance and use of them. The aim of this study was to determine the most important factors affecting the adoption of health information technologies by doing a systematic review on the factors affecting the acceptance of health information technology. METHODS: This systematic review was conducted by searching the major databases, such as Google Scholar, Emerald, Science Direct, Web of Science, Pubmed, and Scopus...
August 2016: Electronic Physician
https://www.readbyqxmd.com/read/27714800/sustained-user-engagement-in-health-information-technology-the-long-road-from-implementation-to-system-optimization-of-computerized-physician-order-entry-and-clinical-decision-support-systems-for-prescribing-in-hospitals-in-england
#18
Kathrin M Cresswell, Lisa Lee, Hajar Mozaffar, Robin Williams, Aziz Sheikh
OBJECTIVE: To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING: Six hospitals in England, United Kingdom. STUDY DESIGN: Qualitative case study. DATA COLLECTION: We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals...
October 7, 2016: Health Services Research
https://www.readbyqxmd.com/read/27713674/impact-of-computerized-provider-order-entry-on-total-parenteral-nutrition-in-the-neonatal-intensive-care-unit
#19
Kyle A Franco, Keliana O'Mara
OBJECTIVES: To determine if computerized provider order entry (CPOE) implementation impacts the time it takes for preterm neonates to reach their parenteral macronutrient goals. METHODS: Retrospective review of neonates <1750 g receiving parenteral nutrition (PN) before and after the implementation of CPOE. Primary outcome was the attainment of parenteral macronutrient goals. Secondary outcomes included time to attainment, the frequency of electrolyte abnormalities, and the incidence of required adjustments made to PN orders by verification pharmacists...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27678459/computerized-prescriber-order-entry-related-patient-safety-reports-analysis-of-2522-medication-errors
#20
Mary G Amato, Alejandra Salazar, Thu-Trang T Hickman, Arbor Jl Quist, Lynn A Volk, Adam Wright, Dustin McEvoy, William L Galanter, Ross Koppel, Beverly Loudin, Jason Adelman, John D McGreevey, David H Smith, David W Bates, Gordon D Schiff
OBJECTIVE: To examine medication errors potentially related to computerized prescriber order entry (CPOE) and refine a previously published taxonomy to classify them. MATERIALS AND METHODS: We reviewed all patient safety medication reports that occurred in the medication ordering phase from 6 sites participating in a United States Food and Drug Administration-sponsored project examining CPOE safety. Two pharmacists independently reviewed each report to confirm whether the error occurred in the ordering/prescribing phase and was related to CPOE...
September 27, 2016: Journal of the American Medical Informatics Association: JAMIA
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