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Related Experiment Videos

Errors associated with applying decision support by suggesting default doses for aminoglycosides.

Saeid Eslami1, Ameen Abu-Hanna, Nicolette F de Keizer

  • 1Department of Medical Informatics, Academic Medical Center, Universiteit van Amsterdam, Amsterdam, The Netherlands. s.eslami@amc.uva.nl

Drug Safety
|September 2, 2006
PubMed
Summary

Computerised physician order entry (CPOE) default doses for gentamycin and tobramycin frequently lead to medication errors and potential adverse drug events (ADEs) in patients with renal insufficiency.

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Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Medication errors and adverse drug events (ADEs) are significant causes of morbidity and mortality.
  • Computerised physician order entry (CPOE) systems aim to reduce medication errors but can introduce new error types.
  • The impact of CPOE default dosing on medication errors and ADEs requires investigation.

Purpose of the Study:

  • To investigate the effect of a CPOE system's default dose for gentamycin and tobramycin on medication errors and potential ADEs.
  • To assess the frequency of CPOE default dose utilization in a tertiary adult intensive care unit.
  • To evaluate the association between default dosing and potential ADEs in patients with renal insufficiency.

Main Methods:

  • Retrospective analysis of gentamycin and tobramycin prescriptions from CPOE records.

Related Experiment Videos

  • Comparison of prescribed doses against a locally developed guideline.
  • Definition of dose prescribing error as exceeding recommended dose by >10%.

    • Main Results:

    • 58% of prescriptions utilized the CPOE default dose of 240 mg/day.
    • 73% of these default orders contained incorrect doses.
    • 86% of default orders for patients with renal insufficiency resulted in potential ADEs.

    Conclusions:

    • A high frequency of prescriptions followed the CPOE default dose.
    • Default dosing in CPOE systems contributes to medication errors and potential ADEs, particularly in patients with renal insufficiency.
    • Fixed default values in CPOE for gentamycin and tobramycin require re-evaluation to improve patient safety.