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Published on: August 1, 2019
The impact of computerized physician order entry on medication errors and adverse drug events
Fatimah Ali Al-Rowibah1, Mustafa Z Younis, Jai Parkash
1Pharmacy Department, Armed Forces Hospital, Al-Kharj, Saudi Arabia.
Insights
Computerized Physician Order Entry (CPOE) implementation at King Fahad Medical City Hospital significantly reduced medication errors and adverse drug events (ADEs). While physicians found CPOE improved performance and productivity, some noted usability challenges and new error types.
Area of Science:
- Health Informatics
- Patient Safety
- Clinical Pharmacy
Background:
- Medication errors and adverse drug events (ADEs) pose significant clinical and economic burdens.
- Computerized Physician Order Entry (CPOE) systems are increasingly adopted to mitigate these risks.
Purpose of the Study:
- To evaluate the impact of CPOE on patient safety and medication error reduction.
- To assess physician perceptions of CPOE's usability and effectiveness at King Fahad Medical City Hospital (KFMCH).
Main Methods:
- A cross-sectional study design was employed.
- Questionnaires were administered to 93 physicians at KFMCH who had used CPOE for over six months.
- Descriptive statistical analyses were conducted on the collected data.
Main Results:
- 88% of physicians reported improved performance, and 76% noted increased productivity with CPOE.
- While 72% agreed CPOE reduced ADEs and 91% found it reduced prescription errors, 55% reported new error types.
- Physician feedback indicated CPOE was perceived as simple (56%) and easy to use (64%), though 44% noted a lack of user guides.
Conclusions:
- CPOE implementation at KFMCH demonstrated a positive impact on reducing medication errors and ADEs.
- Physician adoption of CPOE is associated with perceived improvements in performance and productivity.
- Addressing usability concerns and potential new error types is crucial for optimizing CPOE's benefits.
Objectives:
Medication errors and adverse drug events (ADEs) are common, costly, and clinically important problems. This research was conducted to determine whether computerized physician order entry (CPOE) improves the quality of care by increasing patient safety and decreasing medication errors at the King Fahad Medical City Hospital (KFMCH) of the Kingdom of Saudi Arabia (KSA).
Methods:
The study utilized a cross-sectional research design. Questionnaires were distributed to physicians in various departments who used the system for more than six months. The study was conducted in Riyadh at KFMCH, which is the largest medical complex hospital in the Middle East, in the outpatient setting.
Key Findings:
Ninety-three physicians participated in the study; the response rate was 31 percent. Only descriptive analyses were conducted. Results showed that 88 percent of the physicians agreed that the use of CPOE improved their performance and 76 percent reported that the use of CPOE increased their productivity. In addition, 56 percent of the participants agreed that CPOE was a simple system and 64 percent reported that it was easy to use. However, 44 percent of the physicians agreed that CPOE lacked a user guide during medication ordering and 55 percent reported that it created new types of errors. Results showed that 234 physicians always changed their order, 179 physicians changed their order often, 175 physicians rarely changed their order, and 74 physicians never changed their order. Furthermore, 72 percent of the physicians agreed that CPOE helped them to decrease ADEs. Finally, 91 percent of the physicians agreed that CPOE reduced errors related to hand-written prescriptions.
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Pharmacovigilance
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
