Computerized physician order entry (CPOE) has been known as a process of physician orders in an electronic way instead of the traditional paper-based system. CPOE has been included as one of core objectives in the term ‘Meaningful Use’ by Centers for Medicare and Medicaid Services. The U.S. Department of Health and Human Services Office of Inspector General reported 180,000 deaths in the United States in 2008 due to medication errors. The Institute of Medicine reported about 450,000 preventable adverse drug effects which costed additional $3.5 billion. On average, 1.7 medication errors per day and 74.5% errors in parenteral drugs administration were reported in the intensive care unit (ICU). The purpose of this research was to examine the benefits, barriers and risks of CPOE adoption in different ICUs. The methodology for this study was a literature review. Research was conducted by collecting scholarly online database and government websites. On one hand, CPOE could provide patient’s health record regardless of time and place, alerts in drug interactions, and suggest in clinical decisions in ICUs. CPOE could also reduce medication errors and adverse drug events significantly. On the other hand, CPOE could provide better solutions if it would be used with real-time conversation and as per workflow of ICUs. In addition, user satisfaction and sufficient training, were important factors in implementing CPOE with more successful and desired outcomes.
CPOE, Medication Errors, Adverse Drug Events, Intensive Care Units
- Aspden, P., Wolcott, J. A., Bootman, J. L. & Cronenwett, L. R. (2007). Committee on identifying and preventing medication errors: Preventing medication errors. Washington, DC: National Academies Press.
- Camiré, E., Moyen, E., & Stelfox, H. T. (2009). Medication errors in critical care: Risk factors, prevention and disclosure. Canadian Medical Association Journal, 180(9), 936-943. https://doi.org/10.1503/cmaj.080869.
- Centers for Medicare & Medicaid Services (CMS), HHS. (2010). Medicare and Medicaid programs; electronic health record incentive program. Final rule. Federal Register, 75(144), 44313-588. PMID: 20677415.
- Cho, I., Park, H., Choi, Y. J., Hwang, M. H., & Bates, D. W. (2014). Understanding the nature of medication errors in an ICU with a computerized physician order entry system. PLoS One, 9(12), e114243. https://doi.org/10.1371/journal.pone.0114243.
- Colpaert, K., Claus, B., Somers, A., Vandewoude, K., Robays, H., & Decruyenaere, J. (2006). Impact of computerized physician order entry on medication prescription errors in the intensive care unit: A controlled cross-sectional trial. Critical Care, 10(1), R21. https://doi.org/10.1186/cc3983.
- Fumis, R. R. L., Costa, E. L. V., Martins, P. S., Pizzo, V., Souza, I. A., & Schettino, G. D. P. P. (2014). Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study. Revista Brasileira de Terapia Intensiva, 26(1), 1-6. https://doi.org/10.5935/0103-507x.20140001.
- Hoonakker, P. L., Carayon, P., Brown, R. L., Cartmill, R. S., Wetterneck, T. B., & Walker, J. M. (2013). Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units. Journal of the American Medical Informatics Association, 20(2), 252-259. https://doi.org/10.1136/amiajnl-2012-001114.
- Hoonakker, P. L., Carayon, P., & Walker, J. M. (2010). Measurement of CPOE end-user satisfaction among ICU physicians and nurses. Applied Clinical Informatics, 1(3), 268-285. https://doi.org/10.4338/aci-2010-03-ra-0020.
- Hundt, A. S., Adams, J. A., Schmid, J. A., Musser, L. M., Walker, J. M., Wetterneck, T. B., ... & Carayon, P. (2013). Conducting an efficient proactive risk assessment prior to CPOE implementation in an intensive care unit. International Journal of Medical Informatics, 82(1), 25-38. https://doi.org/10.1016/j.ijmedinf.2012.04.005.
- Joint Commission on Accreditation of Healthcare Organizations. (2008). Safely implementing health information and converging technologies. Sentinel Event Alert, 42, 1-4. PMID: 19108351.
- Makary, M. A., & Daniel, M. (2016). Medical error-the third leading cause of death in the US. The BMJ, 353, i2139. https://doi.org/10.1136/bmj.i2139.
- Maslove, D. M., Rizk, N., & Lowe, H. J. (2011). Computerized physician order entry in the critical care environment: A review of current literature. Journal of Intensive Care Medicine, 26(3), 165-171. https://doi.org/10.1177/0885066610387984.
- Nuckols, T. K., Smith-Spangler, C., Morton, S. C., Asch, S. M., Patel, V. M., Anderson, L. J., ... & Shekelle, P. G. (2014). The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: A systematic review and meta-analysis. Systematic Reviews, 3(1), 56. https://doi.org/10.1186/2046-4053-3-56.
- Recovery Act. (2009). American Recovery and Reinvestment Act of 2009. Public Law, 111(5), 5-30.
- Romanow, D., Rai, A., Keil, M., & Luxenberg, S. (2017). Does extended CPOE use reduce patient length of stay?. International Journal of Medical Informatics, 97, 128-138. https://doi.org/10.1016/j.ijmedinf.2016.09.012.
- Shulman, R., Singer, M., Goldstone, J., & Bellingan, G. (2005). Medication errors: A prospective cohort study of hand-written and computerised physician order entry in the intensive care unit. Critical Care, 9(5), R516. https://doi.org/10.1186/cc3793.
- Vaidya, V., Sowan, A. K., Mills, M. E., Soeken, K., Gaffoor, M., & Hilmas, E. (2006). Evaluating the safety and efficiency of a CPOE system for continuous medication infusions in a pediatric ICU. AMIA Annual Symposium Proceedings, 2006, 1128. PMID: 17238747; PMCID: PMC1839548.
- Valentin, A., Capuzzo, M., Guidet, B., Moreno, R., Metnitz, B., Bauer, P., & Metnitz, P. (2009). Errors in administration of parenteral drugs in intensive care units: Multinational prospective study. The BMJ, 338, b814. https://doi.org/10.1136/bmj.b814.
- Wolfstadt, J. I., Gurwitz, J. H., Field, T. S., Lee, M., Kalkar, S., Wu, W., & Rochon, P. A. (2008). The effect of computerized physician order entry with clinical decision support on the rates of adverse drug events: A systematic review. Journal of General Internal Medicine, 23(4), 451-458. https://doi.org/10.1007/s11606-008-0504-5.
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