Prevention of potential errors in resuscitation medications orders by means of a computerised physician order entry in paediatric critical care

SummaryIntroductionComputerised physician order entry with clinical decision support system (CPOE + CDSS) is an important tool in attempting to reduce medication errors. The objective of this study was to evaluate the impact of a CPOE + CDSS on (1) the frequency of errors in ordering resuscitation (CPR) medications and (2) the time for printing out the order form, in a paediatric critical care department (PCCD).MethodsSetting: An 18-bed PCCD in a tertiary-care children's hospital. Design: Prospective cohort study. Measures: Compilation and comparison of number of errors and time to fill in forms before and after implementation of CPOE + CDSS. Time to fill in conventional, simulated and CPOE forms was measured and compared.ResultsThere were three reported incidents of errors among 13,124 CPR medications orders during the year preceding implementation of CPOE + CDSS. These represent errors that escaped the triple check by three independent staff members. There were no errors after CPOE + CDSS was implemented (100% error reduction for 46,970 orders). Time to completion of drug forms dropped from 14 min 42 s to 2 min 14 s (p < 0.001).ConclusionsCPOE + CDSS completely eliminated errors in filling in the forms and significantly reduced time to completing the form.