Retrospective evaluation of a computerized physician order entry adaptation to prevent prescribing errors in a pediatric emergency department.

摘要: Medication errors are a constant challenge for providers and have potentially serious consequences patients. Pediatric populations at unique significant risks with respect to medical errors.1 The use of weight-based dosing, off-label drug usage, limited reserves withstand dosing errors, inability communicate health care personnel prevent an error or signal that one has occurred contributing factors.2,3 Children pharmacokinetic pharmacodynamic differences, compared adults, which make them more susceptible medication errors. Small calculation may translate into large complications, such as decimal causing 10-fold dose increase.4 emergency department (ED) environment presents additional risk because the nature provided, high patient volume, stress, noise, time pressures, unfamiliar patients.1 Therefore, pediatric ED is particularly It estimated prescribing occur in 10% visits ED.5 To date, no studies exist regarding impact computerized physician order entry (CPOE) on ED. Most adverse reactions prescribing.6,7 In inpatient setting, 74% 79% stage ordering, most frequent type was error.6,7 CPOE been shown reduce rates hospitalized children.8,9 However, recent little effect some systems preventing populations, new, computer-related sometimes emerge.10 Despite these shortcomings, supported by Institute Medicine, Leapfrog Group, Safe Practices, American Medical Association, Academy Pediatrics, others safety practice implement.11–18 CPOE used conjunction decision support adults.13,14,19 Examples include suggested regimens age-specific doses, drug-drug interaction warnings, allergy warnings. A system targeted (eg, creatinine clearance renal antibiotics) be effective adult patients insufficiency.20 study involving 1933 children from 3 maintenance organizations, electronic prescription ordering without did not lower potential outpatient prescriptions,21 suggests necessary children. pediatrics-specific clinical way harmful inpatients.7 In effort we designed quicklist provides supplying pediatric, doses formulary-approved drugs commonly prescribed medications our ED. purpose this determine whether addition reduced rate