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Impact of computerized physician order entry system on parenteral nutrition medication errors in a teaching neonatal
A Abbassi1, N Hasni2, E B Ben Hamida3
1Department of Pharmacy, Charle-Nicolle Hospital, 1006 Tunis, Tunisia.
Insights
Implementing a computerized physician order entry (CPOE) system significantly reduced parenteral nutrition (PN) medication errors in neonatology. This technology enhances medication safety for newborns, decreasing errors by over 60%.
Area of Science:
- Neonatal medicine
- Clinical pharmacy
- Health informatics
Background:
- Parenteral nutrition (PN) is crucial for neonates unable to tolerate enteral feeding.
- PN administration carries a heightened risk of medication errors in newborns.
- Existing safety measures may not fully mitigate these risks.
Purpose of the Study:
- To evaluate the impact of a Computerized Physician Order Entry (CPOE) system on PN medication errors.
- To assess the effectiveness of CPOE in a Tunisian teaching hospital's neonatology department.
- To quantify the reduction in prescribing and preparation errors post-CPOE implementation.
Main Methods:
- A prospective, two-phase interventional study was conducted.
- Data collection occurred pre- and post-CPOE system implementation (December 2018 - March 2019).
- A pharmacist prospectively reviewed PN medication errors in a neonatal intensive care unit.
Main Results:
- CPOE implementation reduced PN order errors by 61.1% (from 379 to 147).
- Prescribing errors decreased by 89.4% (207 to 22), and preparation errors by 43.6% (117 to 66).
- Nutrient intakes aligned with recommended daily intakes post-CPOE, indicating improved accuracy.
Conclusions:
- CPOE systems serve as a protective tool against PN prescription and preparation errors.
- Implementing CPOE significantly enhances medication safety and quality for newborns receiving PN.
- CPOE, alongside existing recommendations, is vital for reducing PN medication error risks.
Objectives:
Parenteral nutrition (PN) offers a quality therapeutic option when enteral feeding is non-tolerated or impossible. However, it can be associated with an increased risk of medical errors, especially in sensitive populations such as newborns. This study aimed at determining the impact of the implementation of a computerized physician order entry (CPOE) system on PN medication errors in the neonatology department in the largest teaching hospital in Tunisia.
Materiel And Methods:
The frequency of medication errors in PN, in a teaching neonatal intensive care unit, was prospectively reviewed by a pharmacist between December 2018 and March 2019 in a two-phase interventional study (pre and post locally developed CPOE System implementation).
Results:
Implementation of CPOE system decreased PN order errors from 379 to 147 representing a 61.1% reduction. The decreases on PN order errors per stage, i.e. prescribing and preparation, were form 207 to 22 (89.4%), and from 117 to 66 (43.6%), respectively. Mean nutrients intakes were in conformity to the recommended daily intakes during the CPOE phase of the study. CPOE is a protective tool against prescription and preparation errors. It significantly impacted all items of the ordering process.
Conclusions:
In addition to the rigorous application of the recommendations, the CPOE system allows to reduce the risk of PN medication errors. This improves the safety and quality of medicines in newborns.
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