Retrospective evaluation of a computerized physician order entry adaptation to prevent prescribing errors in a pediatric emergency department.
Retrospective evaluation of a computerized physician order entry adaptation to prevent prescribing errors in a pediatric emergency department.
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DOI：
10.1542/peds.2007-3064
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发表时间：
2008-10
期刊：
影响因子：
8
通讯作者：
Bauchner H
中科院分区：
文献类型：
--
作者：
Sard BE;Walsh KE;Doros G;Hannon M;Moschetti W;Bauchner H
目的是确定在儿科急诊科的计算机化医嘱输入系统中添加儿科药物清单（快速清单）对药物处方错误的影响。快速清单是一种药物剂量支持工具，针对我们临床环境中最常见的药物。我们回顾性比较了420个随机选择的访客在快速列表引入前后的订单。分析错误率与紧急程度、医生培训水平和患者年龄的关系。检查了快速列表的使用频率和错误率。840例患者就诊（干预前420例，干预后420例）共产生724张用药单，其中处方错误156例（21%）。两组在紧急程度、医生培训水平或患者年龄方面没有差异。每100次就诊的错误率从24次下降到13次，每100次就诊的错误率从31次下降到14次。错误率的降低并没有因急症评分、年龄组或医生培训水平而变化。在干预后组中，30%的订单使用了快速列表。在该组中，当使用快速列表时，错误率为每100个订单1.9个错误，而当不使用快速列表时，错误率为每100个订单18.3个错误。排除了错误配方、过敏、药物-药物相互作用和违反规则的错误。引入快速清单之后，药物处方错误显著减少。一份包含常用儿科药物剂量支持的清单可能有助于调整为成人设计的计算机化医嘱输入系统，以更有效地为儿科人群服务。
The goal was to determine the impact on medication prescribing errors of adding a pediatric medication list (quicklist) to a computerized physician order entry system in a pediatric emergency department. The quicklist is a drug dosing support tool that targets the most common medications in our clinical setting. We performed a retrospective comparison of orders from 420 randomly selected visits before and after quicklist introduction. Error rates were analyzed with respect to urgency level, physician training level, and patient age. The quicklist was examined for frequency of use and error rates. The 840 patient visits (420 before intervention and 420 after intervention) generated 724 medication orders, which contained 156 medication prescribing errors (21%). The groups did not differ with respect to urgency level, physician training level, or patient age. There were significant decreases in the rate of errors per 100 visits, from 24 to 13 errors per 100 visits, and in the rate of errors per 100 orders, from 31 to 14 errors per 100 orders. The decrease in the error rates did not vary according to urgency score, age group, or physician training level. The quicklist was used in 30% of the orders in the postintervention group. In this group, the error rate was 1.9 errors per 100 orders when the quicklist was used, compared with 18.3 errors per 100 orders when the list was not used. Errors of wrong formulation, allergy, drug-drug interaction, and rule violations were eliminated. The introduction of the quicklist was followed by a significant reduction in medication prescribing errors. A list with dosing support for commonly used pediatric medications may help adapt computerized physician order entry systems designed for adults to serve pediatric populations more effectively.
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影响因子：
8
作者：
Kozer, E;Scolnik, D;Koren, G
通讯作者：
Koren, G
影响因子：
120.7
作者：
Chertow, GM;Lee, J;Bates, DW
通讯作者：
Bates, DW
影响因子：
8
作者：
Fortescue, EB;Kaushal, R;Bates, DW
通讯作者：
Bates, DW
影响因子：
120.7
作者：
Bates, DW;Leape, LL;Seger, DL
通讯作者：
Seger, DL
影响因子：
5.1
作者：
Fernandez, CV;Gillis-Ring, J
通讯作者：
Gillis-Ring, J