Lehmann Christoph U, Kim George R, Gujral Renmeet, Veltri Michael A, Clark John S, Miller Marlene R
Johns Hopkins Children's Medical and Surgical Center, Baltimore, MD, USA.
Pediatr Crit Care Med. 2006 May;7(3):225-30. doi: 10.1097/01.PCC.0000216415.12120.FF.
To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation.
Data on ordering error frequency and typology were collected before and after implementation of an online infusion ordering system. Data on pharmacy preparation errors of infusions were collected.
A children's hospital at an academic medical center.
None. Data were abstracted from infusion orders.
Introduction of a voluntary-use Web-based calculator into infusion ordering workflow. Observation only.
Number and type of errors in handwritten and calculator-generated orders. Number and type of errors in pharmacy infusion preparation.
Before calculator deployment, 129 sequential handwritten infusion orders were collected over 5 weeks. After deployment, of 162 sequential infusion orders, 88% (142) were calculator-generated. Calculator-generated infusion orders contained 83% fewer (p < .001) orders containing one or more errors than handwritten orders. Calculator-generated orders contained no high-risk errors (incorrect decimal, dose, or unit of measure) when compared with handwritten orders and were associated with fewer pharmacy interventions. In 118 sequential pharmacy infusion preparations over 4 wks, there were no errors observed.
A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.
评估基于网络的计算器和决策支持系统对输液医嘱错误的影响，并估计药房输液配置中的错误频率。
在实施在线输液医嘱系统前后收集医嘱错误频率和类型的数据。收集药房输液配置错误的数据。
一所学术医疗中心的儿童医院。
无。数据从输液医嘱中提取。
在输液医嘱工作流程中引入自愿使用的基于网络的计算器。仅观察。
手写医嘱和计算器生成医嘱中的错误数量和类型。药房输液配置中的错误数量和类型。
在部署计算器之前，在5周内收集了129份连续的手写输液医嘱。部署后，在162份连续的输液医嘱中，88%（142份）是由计算器生成的。与手写医嘱相比，计算器生成的输液医嘱中包含一个或多个错误的医嘱减少了83%（p < .001）。与手写医嘱相比，计算器生成的医嘱没有高风险错误（小数点、剂量或计量单位错误），并且与较少的药房干预相关。在4周内的118份连续药房输液配置中，未观察到错误。
基于网络的计算器显著减少了连续儿科输液处方过程中的错误总数，并消除了所有高风险错误。由于在药房配置中未观察到错误，本研究提供了数据支持将计算机化医嘱作为一种独立的安全可行的方法用于开具连续儿科输液医嘱。
