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Factors contributing to medication errors made when using computerized order entry in pediatrics: a systematic

Clare L Tolley1,2,3, Niamh E Forde2, Katherine L Coffey2

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Computerized provider order entry (CPOE) systems in pediatrics can lead to medication errors due to issues like poor dosing alerts and system design. Improving CPOE requires enhanced clinical decision support for accurate medication management.

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Area of Science:

  • Pediatric pharmacology
  • Health informatics
  • Patient safety

Background:

  • Medication errors pose significant risks in pediatric care.
  • Computerized provider order entry (CPOE) systems are widely used but can introduce unique error types.

Purpose of the Study:

  • To identify factors contributing to medication errors in pediatric CPOE use.
  • To provide recommendations for improving CPOE systems in pediatrics.

Main Methods:

  • Systematic literature review of 47 articles across three major databases (CINAHL, Embase, Medline).
  • Independent screening and data extraction by multiple reviewers.
  • Narrative synthesis of eligible studies.

Main Results:

  • Five key factors contributing to CPOE medication errors were identified.
  • These include inadequate or inappropriate dosing/duplication alerts, dropdown menu errors, and system design flaws.
  • Lack of effective drug dosing alerts was a primary concern.

Conclusions:

  • CPOE systems in pediatrics are associated with specific medication error factors.
  • Enhanced clinical decision support, particularly for accurate dose suggestion based on drug indication, is crucial.
  • System improvements are needed to mitigate pediatric medication errors.