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The impact of computerised physician order entry on prescribing in general paediatric units in Hong Kong

Conor Ming-Ho Sin1, Mei Wan Young2, Charles Cheuk Hang Lo1

  • 1Pharmacy Department, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong.

The International Journal of Pharmacy Practice
|March 17, 2021
PubMed

Insights

Computerised Physician Order Entry (CPOE) systems significantly reduced medication prescribing errors in a Hong Kong paediatric unit. While eliminating handwriting errors, CPOE introduced new error types, highlighting the need for careful system design and training.

Area of Science:

  • Medical Informatics
  • Paediatric Pharmacy
  • Health Systems Research

Background:

  • Medication prescribing errors pose a significant risk in paediatric care.
  • Computerised Physician Order Entry (CPOE) systems are implemented to improve medication safety.
  • Evaluating the impact of CPOE on prescribing errors is crucial for optimizing healthcare delivery.

Purpose of the Study:

  • To assess the effect of a closed-loop CPOE system on medication prescribing errors in a Hong Kong paediatric unit.
  • To analyze changes in the characteristics of prescribing errors before and after CPOE implementation.

Main Methods:

  • A single-site, prospective, observational study was conducted in a public hospital's general paediatric unit.
  • Data on medication orders and prescribing errors were collected pre- and post-CPOE implementation (March-April 2019 and 2020).
  • Error characteristics analyzed included severity, patient age group, drug formulation, and drug class.

Main Results:

  • The prescribing error rate decreased significantly from 6.7% to 3.9% post-CPOE implementation.
  • Handwriting-related errors were eliminated, and dosage selection errors were reduced.
  • New error types emerged, including missing patient information, potentially delaying medication dispensing.

Conclusions:

  • CPOE systems demonstrably reduce prescribing errors and modify error profiles in paediatric settings.
  • System design flaws and insufficient user training can introduce novel errors.
  • Optimizing CPOE implementation requires attention to user training and system interface design to maximize safety benefits.
Abstract

Keywords:
electronic prescribingpatient safetypharmaceutical careprescribing errors

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