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El papel de los sistemas informatizados de entrada de órdenes médicas para facilitar los errores de medicación
Ross Koppel1, Joshua P Metlay, Abigail Cohen
1Department of Sociology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19104 USA. rkoppel@sas.upenn.edu
JAMA
|March 10, 2005
Resumen
Los sistemas computarizados de entrada de órdenes médicas (CPOE) pueden introducir nuevos riesgos de errores de medicación. Este estudio encontró 22 tipos de errores facilitados por CPOE, con muchos que ocurren semanalmente.
Área de la Ciencia:
- Informática de la salud Informática de la salud.
- La seguridad del paciente.
- Farmacia Clínica Farmacia clínica es la especialidad de la farmacia clínica.
Sus antecedentes:
- Los sistemas informatizados de entrada de órdenes médicas (CPOE) de los hospitales están destinados a reducir los errores de medicación, una fuente importante de daños prevenibles.
- A pesar de las tasas de reducción de errores reportadas, el potencial de CPOE para introducir nuevos tipos de errores sigue siendo poco investigado.
Objetivo del estudio:
- Identificar y cuantificar el papel del CPOE en la facilitación de los riesgos de errores de prescripción.
- Investigar cómo los sistemas CPOE pueden conducir inadvertidamente a errores de medicación.
Principales métodos:
- Un estudio de métodos mixtos que combina enfoques cualitativos (entrevistas, grupos focales, observación) y cuantitativos (encuestas).
- Implicó al personal de la casa, médicos, enfermeras y líderes hospitalarios en un hospital docente de atención terciaria durante un período de dos años.
- Centrado en la interacción del personal de la casa con el sistema CPOE para capturar el uso en el mundo real y los problemas potenciales.
Principales resultados:
- Identificó 22 tipos distintos de riesgos de errores de medicación facilitados por el sistema CPOE.
- Los errores comunes incluyen pantallas fragmentadas, mala interpretación de los datos de la farmacia, alertas ignoradas, separaciones funcionales que conducen a dosis dobles y formatos de pedido inflexibles.
- Más del 75% del personal de la casa informó haber observado estos riesgos de error semanalmente o con más frecuencia.
Conclusiones:
- Los sistemas líderes de CPOE con frecuencia pueden facilitar los riesgos de errores de medicación, en contra de su propósito previsto.
- Los médicos y las instituciones de salud deben abordar de manera proactiva los errores inducidos por el CPOE junto con los errores que evitan.
- El diseño y la implementación del sistema requieren una atención cuidadosa para mitigar los riesgos de seguridad del paciente recién introducidos.
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