Journal
JOURNAL OF MEDICAL SYSTEMS
Volume 35, Issue 1, Pages 25-37Publisher
SPRINGER
DOI: 10.1007/s10916-009-9338-x
Keywords
Medical order entry systems; Decision support systems, clinical; Medication errors; Infant, newborn; Patient safety; Iran
Funding
- World Bank
- National Public Health Management Centre (NPMC), Tabriz, Iran
- Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
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Medication dosing errors are frequent in neonatal wards. In an Iranian neonatal ward, a 7.5 months study was designed in three periods to compare the effect of Computerized Physician Order Entry (CPOE) without and with decision support functionalities in reducing non-intercepted medication dosing errors in antibiotics and anticonvulsants. Before intervention (Period 1), error rate was 53%, which did not significantly change after the implementation of CPOE without decision support (Period 2). However, errors were significantly reduced to 34% after that the decision support was added to the CPOE (Period 3; P < 0.001). Dose errors were more often intercepted than frequency errors. Over-dose was the most frequent type of medication errors and curtailed-interval was the least. Transcription errors did not reduce after the CPOE implementation. Physicians ignored alerts when they could not understand why they appeared. A suggestion is to add explanations about these reasons to increase physicians' compliance with the system's recommendations.
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