Pediatric Medication Errors and Computerized Orders

儿科用药错误和计算机化订单

• 批准号: 6764275
• 负责人: Howard Bauchner
• 金额: $ 6.08万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6764275
• 关键词: automated medical record system; child health care personnel; clinical research; computer assisted patient care; computer system design /evaluation; health care facility information system; health services research tag; human subject; patient care management; patient safety /medical error; pediatrics

DESCRIPTION (provided by applicant): Medical errors are a critical public health risk and are largely avoidable. Although hospitalized children suffer from three times the rate of potentially dangerous medical errors compared to adults, many interventions 3roposed to reduce hospital errors have not been evaluated in children. One intervention proven effective in adult patients is the use of computerized physician order entry systems (CPOES). CPOES reduce inpatient medication errors by 55%. Three more than half of the nation's hospitals are planning to implement CPOES in the future. The effect of these systems on errors in hospitalized children has not been well described. Since children suffer from different types of inpatient errors than adults, it is conceivable that the effect of CPOES in children may be different. In addition, the impact of CPOES laboratory menus and alerts on the volume of inpatient laboratories ordered has not been described. This information is important to lab resource allocation and quality control during implementation of CPOES. Lastly, whenever a new system is implemented at a hospital, new errors are expected to occur. The types of new errors that emerge with implementation of CPOES have not been studied. The aims of this study are: (1) to evaluate the effect of CPOES at Boston Medical Center (BMC) on the number of medication errors in the inpatient pediatric wards; (2) to qualitatively describe changes in the types of pediatric medication errors after the implementation of CPOES; and (3) to measure changes in laboratory ordering practices before and after the implementation of CPOES. The change in slope of errors over time will be measure in order to account for a baseline declining rate of medication errors at BMC. The success of this proposed study will help those hospitals investing in CPOES understand its impact on children. Information on new types of errors will allow hospitals implementing CPOES to take measures to prevent or reduce these errors in the future.

描述（由申请人提供）： 医疗错误是一个严重的公共卫生风险，在很大程度上可以避免。尽管住院的儿童与成人相比遭受了潜在危险的医疗错误率的三倍，但尚未在儿童中评估许多干预措施以减少医院错误。一项对成年患者有效的干预措施是使用计算机医师订购系统（CPOES）。 CPOE将住院用药错误减少55％。 该国三个以上的医院计划将来实施CPOE。这些系统对住院儿童错误的影响尚未得到很好的描述。由于儿童遭受了与成年人不同类型的住院错误，因此可以想象CPOE在儿童中的影响可能有所不同。此外，尚未描述CPOES实验室菜单和警报对被命令的住院实验室数量的影响。此信息对于实施CPOE期间的实验室资源分配和质量控制很重要。最后，每当在医院实施新系统时，都会发生新的错误。尚未研究通过CPOE实现出现的新错误的类型。这项研究的目的是：（1）评估CPOE在波士顿医疗中心（BMC）对住院儿科病房中药物错误数量的影响； （2）在实施CPOE后定性描述小儿药物错误类型的变化； （3）在实施CPOE之前和之后衡量实验室订购实践的变化。随着时间的流逝，错误斜率的变化将是衡量的，以说明BMC在BMC处的药物错误率下降。这项拟议的研究的成功将帮助那些投资CPOE的医院了解其对儿童的影响。有关新类型错误的信息将使实施CPOE的医院能够采取措施预防或减少这些错误。