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Effect-evaluation of a computerized physician order entry system with integrated clinical decision support on medication administration errors.

Wegmann, U. (2013) Effect-evaluation of a computerized physician order entry system with integrated clinical decision support on medication administration errors.

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Abstract:Objective: To evaluate the effect of computerized physician order entry (CPOE) with integrated clinical decision support (CDS) on medication administration errors (MAE), error types and causes and how these differ between medical and surgical units in a general hospital in the Netherlands (506 beds). Methods: Effect-evaluation of CPOE/CDS based on disguised observations of 3,402 opportunities for error (OE) at four nursing units (oncology, pulmonology, surgery, orthopedics). Main outcome parameters were differences in MAE percentages between the baseline and the follow-up measurement and between medical and surgical units. Results: MAE percentages excluding wrong time errors significantly decreased (9.3% to 5.8%) at pulmonology, while at oncology no significant changes were found (11.9% to 10.5%). Including wrong time errors, MAE percentages significantly increased (oncology: 19.7% to 36.4%; pulmonology: 20.3% to 31.1%). No significant differences in MAE percentages were found between surgical (32.5% resp. 9.1%) and medical units (33.6% resp. 8.0%). Most frequently occurring errors were wrong time, omission, unauthorized drug and wrong dosage form errors. Conclusion: The implementation of CPOE/CDS seems to have had a positive effect on the MAE percentage excluding wrong time errors. However, the error types should be considered separately to see this effect, because it seems to be overshadowed by new cultural issues and impaired coordination of workflows. No significant differences in MAE percentages between medical and surgical units were found.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/63868
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