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https://www.readbyqxmd.com/read/28905978/redesign-of-computerized-decision-support-to-improve-antimicrobial-prescribing-a-controlled-before-and-after-study
#1
Melissa Baysari, Melissa T Baysari, Jessica Del Gigante, Maria Moran, Indy Sandaradura, Ling Li, Katrina L Richardson, Anmol Sandhu, Elin C Lehnbom, Johanna I Westbrook, Richard O Day
OBJECTIVE: To determine the impact of the introduction of new pre-written orders for antimicrobials in a computerized provider order entry (CPOE) system on 1) accuracy of documented indications for antimicrobials in the CPOE system, 2) appropriateness of antimicrobial prescribing, and 3) compliance with the hospital's antimicrobial policy. Prescriber opinions of the new decision support were also explored to determine why the redesign was effective or ineffective in altering prescribing practices...
September 13, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28829650/user-acceptance-factors-of-hospital-information-systems-and-related-technologies-systematic-review
#2
Putu Wuri Handayani, Achmad Nizar Hidayanto, Indra Budi
This study reviews the literature on the most important acceptance factors associated with Hospital Information Systems (HIS) and related technologies based on user groups' perspectives (medical staff, hospital management, administrative personnel, patient, medical student, and IT staff), which can assist researchers and hospital management to develop suitable acceptance models to improve the quality of HIS. We conducted searches in online databases with large repositories of academic studies, written in English and fully accessible by the authors...
August 22, 2017: Informatics for Health & Social Care
https://www.readbyqxmd.com/read/28754812/outpatient-cpoe-orders-discontinued-due-to-erroneous-entry-prospective-survey-of-prescribers-explanations-for-errors
#3
Thu-Trang T Hickman, Arbor Jessica Lauren Quist, Alejandra Salazar, Mary G Amato, Adam Wright, Lynn A Volk, David W Bates, Gordon Schiff
BACKGROUND: Computerised prescriber order entry (CPOE) systems users often discontinue medications because the initial order was erroneous. OBJECTIVE: To elucidate error types by querying prescribers about their reasons for discontinuing outpatient medication orders that they had self-identified as erroneous. METHODS: During a nearly 3 year retrospective data collection period, we identified 57 972 drugs discontinued with the reason 'Error (erroneous entry)...
July 28, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28750908/a-systematic-review-of-the-effectiveness-of-interruptive-medication-prescribing-alerts-in-hospital-cpoe-systems-to-change-prescriber-behavior-and-improve-patient-safety
#4
REVIEW
N Page, M T Baysari, J I Westbrook
OBJECTIVES: To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. METHODS: PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28713798/incidence-and-severity-of-prescribing-errors-in-parenteral-nutrition-for-pediatric-inpatients-at-a-neonatal-and-pediatric-intensive-care-unit
#5
Theresa Hermanspann, Mark Schoberer, Eva Robel-Tillig, Christoph Härtel, Rangmar Goelz, Thorsten Orlikowsky, Albrecht Eisert
OBJECTIVES: Pediatric inpatients are particularly vulnerable to medication errors (MEs), especially in highly individualized preparations like parenteral nutrition (PN). Aside from prescribing via a computerized physician order entry system (CPOE), we evaluated the effect of cross-checking by a clinical pharmacist to prevent harm from PN order errors in a neonatal and pediatric intensive care unit (NICU/PICU). METHODS: The incidence of prescribing errors in PN in a tertiary level NICU/PICU was surveyed prospectively between March 2012 and July 2013 (n = 3,012 orders)...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28698381/reasons-for-computerised-provider-order-entry-cpoe-based-inpatient-medication-ordering-errors-an-observational-study-of-voided-orders
#6
Joanna Abraham, Thomas G Kannampallil, Alan Jarman, Shivy Sharma, Christine Rash, Gordon Schiff, William Galanter
OBJECTIVE: Medication voiding is a computerised provider order entry (CPOE)-based discontinuation mechanism that allows clinicians to identify erroneous medication orders. We investigated the accuracy of voiding as an indicator of clinician identification and interception of a medication ordering error, and investigated reasons and root contributors for medication ordering errors. METHOD: Using voided orders identified with a void alert, we conducted interviews with ordering and voiding clinicians, followed by patient chart reviews...
July 11, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28653940/review-medication-errors-and-strategies-for-their-prevention
#7
REVIEW
Muhammad Kashif Riaz, Mohammad Riaz, Abida Latif
Medication errors occur every day causing injury to the patients and even deaths. The health care professionals are not fully aware of the damages done by medication errors in terms of patients' discomfort and economic burden. There is a need to provide information about medication errors to health care providers. This article reviews research done on the various aspects of medication errors. The research work done on prescribing errors, transcribing errors, dispensing errors, administration errors and discharged summaries errors have been examined...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28653914/chemotherapy-related-risk-management-toward-safe-administration-of-medications-apply-failure-mode-and-effects-analysis-to-reduce-the-incidence-of-chemotherapy-errors
#8
Linrun Wang, Ying Li, Yan Lou, Guobing Zhang, Jian Chen, Yang Wang, Xingguo Zhang
Chemotherapy is considered a high-risk procedure where system failures are more likely to occur. Failure mode and effects analysis (FMEA) is a systematic, multidisciplinary team-based approach to error prevention. We described our experience of using FMEA as a prospective risk-management technique throughout the chemotherapy process. The occurrence, detectability and severity were assessed. Fifteen potential risk factors associated with 10 failure modes were identified. Improvement measures were proposed according to risk priority number...
May 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28566988/the-impact-of-order-source-misattribution-on-computerized-provider-order-entry-cpoe-performance-metrics
#9
George A Gellert, Linda Catzoela, Lajja Patel, Kylynn Bruner, Felix Friedman, Ricardo Ramirez, Lilliana Saucedo, S Luke Webster, John A Gillean
BACKGROUND: One strategy to foster adoption of computerized provider order entry (CPOE) by physicians is the monthly distribution of a list identifying the number and use rate percentage of orders entered electronically versus on paper by each physician in the facility. Physicians care about CPOE use rate reports because they support the patient safety and quality improvement objectives of CPOE implementation. Certain physician groups are also motivated because they participate in contracted financial and performance arrangements that include incentive payments or financial penalties for meeting (or failing to meet) a specified CPOE use rate target...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/28551000/physician-satisfaction-with-transition-from-cpoe-to-paper-based-prescription
#10
N Griffon, M Schuers, M Joulakian, M Bubenheim, J-P Leroy, S J Darmoni
INTRODUCTION: In January 2015, Rouen University Hospital's information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider order entry (POE) systems. METHODS: All residents were asked to fill an augmented version of the POE satisfaction and usage survey for both POE systems...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550997/prescription-errors-related-to-the-use-of-computerized-provider-order-entry-system-for-pediatric-patients
#11
Kamel Alhanout, Sok-Siya Bun, Karine Retornaz, Laurent Chiche, Nathalie Colombini
OBJECTIVES: To evaluate the nature and frequency of medication errors resulting from the use of a computerized provider order-entry (CPOE) system in a pediatric department. METHODS: We conducted a retrospective study to examine errors related to computerized orders using the software Pharma(®) (Computer Engineering, France) in pediatric department between 31/05/2015 to 01/12/2015. These errors were signaled by pharmacists who examine CPOEs daily. RESULTS: A total of 302 pharmacist interventions (PharmInt) were carried out by clinical pharmacists during the study period...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28540465/technology-induced-errors-associated-with-computerized-provider-order-entry-software-for-older-patients
#12
Manuel Vélez-Díaz-Pallarés, Ana María Álvarez Díaz, Teresa Gramage Caro, Noelia Vicente Oliveros, Eva Delgado-Silveira, María Muñoz García, Alfonso José Cruz-Jentoft, Teresa Bermejo-Vicedo
Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital. Method Prospective observational 6-month study...
August 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28515507/implementing-a-tech-check-tech-program-at-a-university-health-system
#13
Scott A Tarver, Javier Palacios, Reed Hall, A Crystal Franco-Martinez
Background: Tech-Check-Tech (TCT) allows a pharmacy technician to perform the final check of medications prepared by another technician. The effect of a TCT program on the time required to process medications in a hospital pharmacy has not been previously reported. Objective: To evaluate the effect of implementing a TCT program on the time required to prepare, check, and deliver medications to automated medication supply systems (AMSS) located throughout an academic medical center. Methods: The primary outcome was the difference in mean total time required to process AMSS medications between pre- and post-implementation periods...
April 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28395016/impact-of-commercial-computerized-provider-order-entry-cpoe-and-clinical-decision-support-systems-cdsss-on-medication-errors-length-of-stay-and-mortality-in-intensive-care-units-a-systematic-review-and-meta-analysis
#14
Mirela Prgomet, Ling Li, Zahra Niazkhani, Andrew Georgiou, Johanna I Westbrook
Objective: To conduct a systematic review and meta-analysis of the impact of commercial computerized provider order entry (CPOE) and clinical decision support systems (CDSSs) on medication errors, length of stay (LOS), and mortality in intensive care units (ICUs). Methods: We searched for English-language literature published between January 2000 and January 2016 using Medline, Embase, and CINAHL. Titles and abstracts of 586 unique citations were screened. Studies were included if they: (1) reported results for an ICU population; (2) evaluated the impact of CPOE or the addition of CDSSs to an existing CPOE system; (3) reported quantitative data on medication errors, ICU LOS, hospital LOS, ICU mortality, and/or hospital mortality; and (4) used a randomized controlled trial or quasi-experimental study design...
March 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28378024/examining-perceptions-of-computerized-physician-order-entry-in-a-neonatal-intensive-care-unit
#15
Kristyn S Beam, Megan Cardoso, Megan Sweeney, Geoff Binney, Saul N Weingart
BACKGROUND: Computerized provider order entry (CPOE) is a technology with potential to transform care delivery. While CPOE systems have been studied in adult populations, less is known about the implementation of CPOE in the neonatal intensive care unit (NICU) and perceptions of nurses and physicians using the system. OBJECTIVE: To examine perceptions of clinicians before and after CPOE implementation in the NICU of a pediatric hospital. METHODS: A cross-sectional survey of clinicians working in a Level III NICU was conducted...
April 5, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28356167/sgem-hot-off-the-press-computer-provider-order-entry-cpoe-and-emergency-department-flow
#16
Katie Lin, Kenneth Chan, Rohit Mohindra, Ken Milne, Brent Thoma, Chris Bond
No abstract text is available yet for this article.
March 2017: CJEM
https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#17
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
#18
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
#19
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...
May 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28186069/the-impact-of-computerized-provider-order-entry-on-nursing-practice
#20
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
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