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Prevention of Errors in Resuscitation Medications Orders by Means of a Computerized Physician Order Entry

This study has been completed.
Sponsor:
Information provided by:
Sheba Medical Center
ClinicalTrials.gov Identifier:
NCT00297609
First received: February 27, 2006
Last updated: NA
Last verified: February 2006
History: No changes posted

February 27, 2006
February 27, 2006
January 2002
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Prevention of Errors in Resuscitation Medications Orders by Means of a Computerized Physician Order Entry
Prevention of Potential Errors in Resuscitation Medications Orders by Means of a Computerized Physician Order Entry With Clinical Decision Support System in Pediatric Critical Care – a Prospective Cohort Study.

Computerized physician order entry with clinical decision support system CPOE+CDSS)completely eliminated errors in filling in the resuscitation medications order forms and significantly reduced time to completing the forms in a pediatric critical care department (PCCD).

Introduction: Computerized physician order entry with clinical decision support system (CPOE+CDSS) is an important tool in attempting to reduce medication errors. The objective of this study was to evaluate the impact of a CPOE+CDSS on (1) the frequency of errors in ordering resuscitation (CPR) medications and (2) the time for printing out the order form, in a pediatric critical care department (PCCD).

Methods: Setting: An 18-bed PCCD in a tertiary-care children’s hospital. Design: Prospective cohort study. Measures: Compilation and comparison of number of errors and time to fill in forms before and after implementation of CPOE+CDSS. Errors were identified by reviewing orders and classified as potential adverse drug events (ADEs), medication prescribing errors (MPEs), and rule violations (RVs). They were compared during the year preceding and following implementation of CPOE CDSS. Simulated forms were also used to further test error occurrence. Time to fill in conventional, simulated and CPOE forms was measured and compared.

Results: There were 3 reported incidents of errors among 13,124 CPR medications orders during the year preceding implementation of CPOE+CDSS. These represent errors that escaped the triple check by three independent staff members (two nurses and one physician). There was an average of 11.6 errors/100 orders in the simulated CPR form and potential ADEs occurred at a rate of 11.3/100 orders and MPEs at a rate of 0.3/100 orders. There were no errors after CPOE+CDSS was implemented (100% error reduction). Time to completion of drug forms dropped from 14 min 42 sec to 2 min 14 sec (p<0.001).

Conclusions: CPOE+CDSS completely eliminated errors in filling in the forms and significantly reduced time to completing the form.
Observational
Observational Model: Defined Population
Observational Model: Natural History
Time Perspective: Longitudinal
Time Perspective: Prospective
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  • Critical Care
  • Pediatrics
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
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Inclusion Criteria:

  • all admissions to PICU January 2002 - August 2006

Exclusion Criteria:

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Both
up to 18 Years
No
Contact information is only displayed when the study is recruiting subjects
Israel
 
NCT00297609
SHEBA-03-0000-AV-CTIL
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Sheba Medical Center
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Principal Investigator: Amir Vardi, MD Sheba Medical Center
Sheba Medical Center
February 2006

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP