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Improving IV Insulin Administration in a Community Hospital

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Effects of a Computerized Prescriber Order Entry System on Pharmacist Prescribing.

Stephanie Metzger¹, Christopher Evernden², Tammy J Bungard³

¹, PharmD, ACPR, is with Pharmacy Services, Alberta Health Services, Edmonton, Alberta.

The Canadian Journal of Hospital Pharmacy

|March 31, 2023

Summary

This summary is machine-generated.

Computerized prescriber order entry (CPOE) systems increase pharmacist prescribing, particularly for Schedule I medications. Pharmacists using CPOE also discontinued more orders, indicating enhanced utilization of additional prescribing authority (APA).

Keywords:

computer medical order entry systems pharmacist prescribing

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Area of Science:

Pharmacy Practice
Health Informatics
Pharmacotherapy

Background:

Pharmacists in Alberta possess additional prescribing authority (APA).
University of Alberta Hospital transitioned from paper-based to computerized prescriber order entry (CPOE) systems.

Purpose of the Study:

Quantify changes in pharmacist prescribing post-CPOE implementation.
Compare paper-based and CPOE systems regarding drug schedule, order type, medication class, and clinical practice area.

Main Methods:

Retrospective comparative review of pharmacist orders.
Data collected from 2-week periods in January 2019 (paper-based) and January 2020 (CPOE).

Main Results:

Pharmacists' daily orders increased by a mean of 3.76 with CPOE (p < 0.001).
Schedule I medications represented a higher proportion of prescriptions in CPOE (77.7% vs. 70.5%, p < 0.001).
Discontinuation orders significantly increased with CPOE (58.0% vs. 19.8%, p < 0.001).

Conclusions:

CPOE systems facilitate increased pharmacist prescribing and utilization of APA.
CPOE leads to a higher proportion of Schedule I medication prescriptions.
Pharmacists using CPOE discontinue a greater proportion of orders.