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Development and impact of a computerized pediatric antiinfective decision support program
C J Mullett1, R S Evans, J C Christenson
1Department of Medical Informatics, University of Utah, USA. cmullett@hsc.wvu.edu
Pediatrics
|October 3, 2001
Summary
A pediatric antiinfective decision support tool significantly reduced medication errors and improved drug dosing in a pediatric intensive care unit (PICU). Clinicians found the tool beneficial for antiinfective agent selection and patient safety.
Area of Science:
- Pediatric critical care medicine
- Health informatics
- Pharmacology
Background:
- Computerized decision support systems can enhance care quality and reduce medication errors.
- The Institute of Medicine recommends such tools to minimize pharmaceutical errors.
- Evaluating antiinfective decision support in pediatric intensive care units (PICUs) is crucial.
Purpose of the Study:
- To assess the impact of a tailored antiinfective decision support tool in a PICU.
- To determine if the tool improves antiinfective prescribing and patient outcomes.
Main Methods:
- An existing adult antiinfective tool was adapted for pediatric use.
- Prospective monitoring of process and outcomes during control and intervention periods.
- Mandatory use of the tool for all antiinfective orders in a 26-bed PICU.
Main Results:
- Pharmacy interventions for erroneous doses decreased by 59%.
- Subtherapeutic and excessive antiinfective dose days reduced by 36% and 28%, respectively.
- Estimated antiinfective costs per patient decreased by 9%.
Conclusions:
- The pediatric antiinfective decision support tool was beneficial for patient care in the PICU.
- Clinicians reported improved antiinfective choices and increased awareness of renal function impairments.
- The tool reduced erroneous drug orders and improved therapeutic dosage targets.