Article critique

The article studies the impact of a Computerized physician entry (CPOE ) system on medication errors and adverse drug events (ADEs ) in pediatric inpatients by means of a retrospective cohort study . Two medical wards where CPOE system was in place were compared to one medical and two surgical wards where hand written s continued to be used . There were two working hypotheses : that CPOE system will reduce (i ) the medication error rate (MER ) and (ii ) ADEs . The study demonstrated that the first hypothesis could be empirically proven After the implementation of CPOE , the MER decreased

for 40 on the intervention as compared to the control wards . However , any significant impact of CPOE for ADEs failed to be detected

The intervention was delivered in a reliable and valid manner . In to test the effectiveness of CPOE alone , clinical decision support was not provided and the CPOE system interacted with the laboratory system but not with the pharmacy computer . Both intervention and control wards were clinically independent from one another with respect to nursing staff . The only limitation of the choice of intervention and control group is associated with the insignificant number of patient surveyed and peculiarities of care delivery in medical and surgical wards

As for the measurement system , statistical data on MERs was collected through an adverse event reporting system on each floor . Severity was further classified on the basis of impact on the patient as an ADE (defined as a medication error resulting in an injury to the patient potential ADE , or other

The study concludes that CPOE has proven to be effective in lowering the rate of medication error however , a comprehensive cost-benefit analysis is required before widespread implementation of such systems in clinical settings

References

King , James W , Paice , Naomi , Rangrej , Jagadish , Forestell , Gregory J Ron Swartz (2003 .The Effect of Computerized Physician Entry on Medication Errors and Adverse Drug Events in Pediatric Inpatients Pediatrics 112 : 506-509 . Retrieved October 22 , 2007 , from http /www .pediatrics .org /cgi /content /full /112 /3 /506...