Redundancy in a computer-generated order list: meeting the needs of nurses at various levels of practice expertise

Paper-based clinical practice standards usually pertain to a single diagnosis or clinical condition. When a computerized provider order entry system applies multiple paper-based practice standards to one patient, it generates an order list containing redundant orders. Nurses respond to redundant orders on the basis of their level of nursing expertise with clinical care, computers, and practice standard domains. In this project, orders from three practice standards were manually combined to create a single order list, resulting in 15 duplicate and overlapping orders. A relational database was developed to test the automated removal of redundant orders. As expected, the automatically evaluated order list contained only one of each duplicate order and only the parent of each overlapping order group. Orders were then grouped by related system or function for readability. It is possible to automate the removal of duplicate and overlapping orders from an order list before display to the nurse.