J Clin Outcomes Manage
Impact of computerized provider order entry on hospital medication errors
Roberts DL, Noble BN, Wright MJ, Nelson EA, Shaft JD, Rakela J
Abstract Objective: To assess the impact of a phased implementation of computerized provider order entry (CPOE) on the incidence of medication errors and preventable adverse drug events (ADEs). Design: Retrospective observational analysis. Setting: Mayo Clinic Hospital (Phoenix, AZ), a 232-bed teaching hospital. Participants: All patients admitted to Mayo Clinic Hospital from 6 November 2006 to 7 May 2008. Measurements: Medication errors and preventable ADEs per 1000 patient-days. Results: Relative to the period prior to CPOE implementation, the frequency of medication errors per 1000 patient-days was unchanged during implementation (13.7 vs. 14.1, P = 0.66) and significantly reduced after implementation was completed (10.4 vs. 14.1, P < 0.001). CPOE implementation was associated with a reduced rate of insulin orders containing errors (0.05 vs. 0.20, P = 0.007) but not heparin (0.62 vs. 0.52, P = 0.56). There was a significant decrease in preventable ADEs after implementation (6 vs. 0, P = 0.01). Conclusion: CPOE systems can improve medication safety. Implementing CPOE in a step-wise fashion, rather than all at once, does not appear to have been associated with an increase in medication errors.
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