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Drug prescription before and after implementation of a CPOE system on the Paediatric Intensive Care Unit: a quality

Rebecca Angresius1, Katharina Wyss2, Diana Reppucci3

  • 1Department of Pediatric Surgery, University Children's Hospital Basel (UKBB), Switzerland.

Swiss Medical Weekly
|June 29, 2026
PubMed

Insights

Implementing electronic prescriptions in a paediatric intensive care unit (PICU) significantly improved prescription completeness and standardization. While dose calculation errors decreased, ongoing monitoring and training are crucial for optimizing paediatric medication safety.

Area of Science:

  • Pediatric Intensive Care Medicine
  • Health Informatics
  • Medication Safety

Background:

  • Paediatric drug prescription is complex and prone to errors, especially in the Paediatric Intensive Care Unit (PICU).
  • Electronic prescribing is a national goal in Switzerland to enhance prescription quality and reduce medication errors.
  • This study evaluates prescription quality before and after implementing electronic prescribing in a tertiary Paediatric University Hospital's PICU.

Purpose of the Study:

  • To assess the impact of Computerised Physician Order Entry (CPOE) implementation on the quality of paediatric drug prescriptions.
  • To evaluate changes in dose calculation errors, prescription completeness, and dose compatibility with paediatric dosing standards.

Main Methods:

  • A quality improvement study comparing manual and electronic prescriptions on a PICU during CPOE implementation.
  • Manual prescriptions (April-September 2022) and electronic prescriptions (September-December 2022) were analyzed.
  • Key outcomes included dose calculation errors, adherence to eight quality criteria for complete prescriptions, and dose compatibility with a paediatric dosing standard.

Main Results:

  • Electronic prescriptions showed no dose calculation errors compared to 0.8% in manual prescriptions (p=0.09).
  • Prescription completeness significantly improved, with 47% of electronic prescriptions meeting criteria versus 5% of manual prescriptions (p<0.001).
  • Dose compatibility with the paediatric dosing standard was higher for electronic prescriptions (75%) than manual (68%, p=0.035).

Conclusions:

  • CPOE with integrated dose calculation tools shows potential to enhance paediatric medication safety on PICU by improving prescription completeness and standardization.
  • Despite improvements, only 47% of electronic prescriptions were fully complete, highlighting areas for further optimization.
  • Continuous interdisciplinary monitoring, user training, and system adaptability are essential for maximizing the benefits of electronic prescribing systems.
Abstract

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