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    Medication errors related to computerized order entry for children

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    Authors
    Walsh, Kathleen E.
    Adams, William G.
    Bauchner, Howard C.
    Vinci, Robert J.
    Chessare, John B.
    Cooper, Maureen R.
    Hebert, Pamela M.
    Schainker, Elisabeth G.
    Landrigan, Christopher P.
    UMass Chan Affiliations
    Department of Pediatrics
    Document Type
    Journal Article
    Publication Date
    2006-11-03
    Keywords
    Adolescent
    Child
    Child, Preschool
    Humans
    Infant
    Infant, Newborn
    *Medical Order Entry Systems
    Medication Errors
    Retrospective Studies
    Health Services Research
    Life Sciences
    Medicine and Health Sciences
    Pediatrics
    Primary Care
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    Link to Full Text
    http://dx.doi.org/10.1542/peds.2006-0810
    Abstract
    OBJECTIVE: The objective of this study was to determine the frequency and types of pediatric medication errors attributable to design features of a computerized order entry system. METHODS: A total of 352 randomly selected, inpatient, pediatric admissions were reviewed retrospectively for identification of medication errors, 3 to 12 months after implementation of computerized order entry. Errors were identified and classified by using an established, comprehensive, active surveillance method. Errors attributable to the computer system were classified according to type. RESULTS: Among 6916 medication orders in 1930 patient-days, there were 104 pediatric medication errors, of which 71 were serious (37 serious medication errors per 1000 patient-days). Of all pediatric medication errors detected, 19% (7 serious and 13 with little potential for harm) were computer related. The rate of computer-related pediatric errors was 10 errors per 1000 patient-days, and the rate of serious computer-related pediatric errors was 3.6 errors per 1000 patient-days. The following 4 types of computer-related errors were identified: duplicate medication orders (same medication ordered twice in different concentrations of syrup, to work around computer constraints; 2 errors), drop-down menu selection errors (wrong selection from a drop-down box; 9 errors), keypad entry error (5 typed instead of 50; 1 error), and order set errors (orders selected from a pediatric order set that were not appropriate for the patient; 8 errors). In addition, 4 preventable adverse drug events in drug ordering occurred that were not considered computer-related but were not prevented by the computerized physician order entry system. CONCLUSIONS: Serious pediatric computer-related errors are uncommon (3.6 errors per 1000 patient-days), but computer systems can introduce some new pediatric medication errors that are not typically seen in a paper ordering system.
    Source
    Pediatrics. 2006 Nov;118(5):1872-9. Link to article on publisher's site
    DOI
    10.1542/peds.2006-0810
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/38887
    PubMed ID
    17079557
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1542/peds.2006-0810
    Scopus Count
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