Reduction in chemotherapy order errors with computerized physician order entry.

Area of Science:

• Health Informatics
• Patient Safety
• Oncology Pharmacy

Background:

• Chemotherapy order composition is critical for patient safety.
• Traditional ordering methods like handwritten and preprinted forms are prone to errors.
• Evaluating the impact of evolving ordering systems on error reduction is essential.

Purpose of the Study:

• To quantify and categorize errors in chemotherapy orders across three distinct systems: handwritten, preprinted, and computerized physician order entry (CPOE).
• To compare the error rates associated with each sequential ordering method.

Main Methods:

• A retrospective review of chemotherapy orders by pharmacists from 2008 to 2012.
• Statistical analysis to compare error frequencies between handwritten, preprinted, and CPOE systems.

Main Results:

• Problematic chemotherapy orders requiring rework decreased sequentially: 30.6% (handwritten) to 12.6% (preprinted) to 2.2% (CPOE).
• Errors with the potential to cause patient harm significantly reduced: 4.2% (handwritten) to 1.5% (preprinted) to 0.1% (CPOE).

Conclusions:

• Sequential implementation of preprinted orders and CPOE demonstrably reduced chemotherapy order errors and potential harm.
• CPOE offers substantial safety benefits but does not eliminate all errors and can introduce novel error types.
• Continuous monitoring and vigilance are necessary even with advanced CPOE systems to ensure patient safety.