Computerized physician order entry can almost eliminate medication prescribing errors and ensure nearly full physician compliance with hospital rules in pediatric critical-care units, new research suggests.
In the Jan. 1 issue of Pediatrics, the clinical journal of the American Academy of Pediatrics, researchers from Vanderbilt Children's Hospital in Nashville found that such a system is highly effective in ensuring quality of care among critically ill children and adolescents.
Researchers studied 514 patients in a 20-bed pediatric critical-care unit at the Vanderbilt facility by reviewing a total of 13,828 medication orders in the two months before and the two months after a system was installed and physicians trained on it.
Before implementation, the unit had a rate of 2.2 potential adverse drug events, 30.1 prescribing errors and 6.8 rule violations per 100 orders, according to the study. But the system "resulted in almost a complete elimination" of prescribing errors and rule violations, to 0.2 and 0.1, respectively, per 100 orders, the study said. Potential adverse drug events fell by 40.9%, to 1.3 per 100 orders.
The research team said 79% of potential adverse drug events occur at the time of ordering, but the study did not take into account the fact that actual adverse effects can be prevented at other points in the prescribing process.