Background Paediatric patients involve certain complexities that make them vulnerable to medication errors and adverse patient outcomes. Most of the medication errors occur at the stage of physician ordering and they are often dosing errors. Computerised Physician Order Entry (CPOE) results in legible, structured and complete prescriptions. Furthermore, there is an improvement in the communication between physicians, nurses and pharmacists compared with handwritten orders.
Purpose The objective of this study was to evaluate the impact of CPOE on the frequency of errors in the medication ordering process in a paediatric unit.
Material and methods A prospective observational study was conducted in a 30-bed paediatric unit of a tertiary teaching hospital. The physician’s orders were reviewed for 2 months before and 2 months after CPOE implementation. Medication errors were identified and classified into errors of: dosing, interval, units, route of administration, treatment duration, schedule, wrong drug, incomplete order and rule violation.
Results A total of 1164 orders of 212 patients were reviewed. Before implementation, medication errors occurred at a rate of 3.3 per 100 orders (n=20): 35% (n=7) were dosing errors, 25% (n=5) incomplete orders and 20% (n=4) unit errors. After implementation, the rate was increased to 6.6 per 100 orders (n=37): 24.3% (n=9) were dosing errors, 18.9% (n=7) rule violations, 18.9% (n=7) wrong treatment duration, 13.5% (n=5) schedule errors, 20% (n=4) unit errors and 8.1% (n=3) interval errors.
Conclusion The implementation of CPOE resulted in an increase in the number of medication errors, but the type of them was clearly different. While handwritten errors were the result of calculation errors, missing information or confusion in writing, CPOE errors were mainly due to the inexperience of using the program. The consequences of the CPOE errors were less harmful than handwritten prescription errors.
No conflict of interest
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