Related Experiment Video
Updated: May 20, 2026
08:13
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Computerized clinical decision support for medication prescribing and utilization in pediatrics
Jeremy S Stultz1, Milap C Nahata
1Ohio State University College of Pharmacy, Columbus, Ohio, USA.
Summary
Computerized clinical decision support (CCDS) in pediatrics shows mixed results. While some tools improve prescribing and reduce errors, others have high override rates and unclear patient outcome impacts, necessitating further research.
Area of Science:
- Pediatric pharmacology
- Health informatics
- Clinical decision support systems
Background:
- Accurate medication prescribing is crucial for pediatric patient safety and efficacy.
- Computerized clinical decision support (CCDS) systems integrated with physician order entry aim to enhance prescribing accuracy.
- A comprehensive analysis of existing literature on CCDS in pediatrics is lacking.
Purpose of the Study:
- To analyze the impact of implementing medication-related CCDS functionalities on prescribing and medication use in pediatric patients.
- To synthesize findings from existing research on the effectiveness of various CCDS tools in pediatric settings.
Main Methods:
- A systematic literature search was conducted using PubMed.
- Keywords focused on research studies evaluating outcomes of medication-related CCDS functionalities.
Main Results:
- Medication dosing calculators reduced calculation errors.
- Alert-based CCDS (e.g., duplicate therapy, allergy checks) may lead to alert fatigue.
- Medication interaction CCDS has limited pediatric research.
- Medication dosing support decreased adverse drug events but had high override rates.
- Medication order sets improved guideline adherence.
- Guideline-based recommendations had variable influence on appropriate use, with few demonstrating improved patient outcomes.
Conclusions:
- Certain CCDS functionalities offer benefits in pediatric prescribing.
- Other CCDS tools exhibit high override rates and inconsistent effects on patient care.
- Further research is needed to evaluate individual CCDS functionalities' impact on safe and effective pediatric prescribing and medication use.
Related Concept Videos
01:29Drug Dosing: Infants and Children
Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
01:27Nursing Clinical Information System
Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...