Abstract
Purpose
The purpose of this study was to evaluate the impact of commercial computerized prescriber order entry (CPOE) on efficiency outcomes in an 864-bed community hospital.
Methods
A retrospective study was developed to measure medication errors and medication order turnaround time in St. Luke's Episcopal Hospital located in the Texas Medical Center. The study data were collected by stratified random sampling through a review of medication orders submitted to the pharmacy using a paper-based order system and the CPOE system. Descriptive frequencies, chi-square test, Wilcoxon matched-pairs sign rank test, and logistic regression and multiple regression analyses were conducted to examine the relationship among variables.
Results
Of the 1,110 total orders reviewed (563 paper-based and 547 CPOE), a total of 135 medication errors were found, with 10.5% in paper-based versus 1.6% in CPOE. The most prevalent errors in paper-based orders were inappropriate abbreviations (24.4%), incorrect doses (15.6%), occurrences of allergy (13.3%), and wrong administration frequency (9.6%). In CPOE orders, the errors were occurrences of allergy (10.4%), incorrect doses (2.2%), and drug interaction (0.7%). CPOE resulted in a 50% reduction of medication order turnaround time (median = 24 minutes CPOE vs 48 minutes paper orders). A potential medication error, unidentified prescribers within medication orders, urgency of medication order, and implementation of CPOE were the significant (P < .05) determinants of medication order turnaround time.
Conclusion
The implementation of a commercial CPOE system reduced medication errors and improved medication order turnaround times.
Keywords
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