Hunteman Lori, Ward Leah, Read Diane, Jolly Mona, Heckman Michael
Mayo Clinic, Jacksonville, FL 32224, USA.
Am J Health Syst Pharm. 2009 Feb 15;66(4):373-7. doi: 10.2146/ajhp080328.
Allergy alerts within a computerized prescriber-order-entry (CPOE) system were analyzed.
A retrospective analysis was performed to evaluate inpatient CPOE orders that triggered an allergy alert for one month in November 2007. Data were extracted from a computer-generated report to identify the total number of prescription orders and the number of orders triggering an allergy alert during the study time frame. When overriding an allergy alert from the CPOE system, prescribers had to choose one of three rationales: the benefit outweighs the risk, the patient previously tolerated the medication, and the medication is therapeutically appropriate. Data collected included the number of allergy alerts, allergy alert overrides, override rationale, and patients' demographic information. Descriptive statistics were used to summarize the results.
Allergy alerts were triggered on 643 (1.3%) of the 49,887 total orders entered during the month (95% confidence interval [CI], 1.2-1.4%). Alerts were triggered on a total of 289 patients, with a mean of 2 orders triggering alerts per patient. The median age was 65 years old. The median hospital stay for patients with an order triggering an alert was three days. Overall, 625 of 643 alerts (97%) were overridden for rationales as following: the patient previously tolerated the medication (49%), the benefit outweighed the risk (29%), and the medication was therapeutically appropriate (24%), and a free text explanation (8%).
While a small portion of prescription orders generated through a CPOE system triggered an allergy alert, most of the allergy alerts were overridden by prescribers.
对计算机医嘱录入（CPOE）系统中的过敏警报进行分析。
进行回顾性分析，以评估2007年11月触发过敏警报的住院患者CPOE医嘱。数据从计算机生成的报告中提取，以确定研究时间段内的处方医嘱总数以及触发过敏警报的医嘱数量。当医生忽略CPOE系统中的过敏警报时，必须选择以下三种理由之一：益处大于风险、患者先前耐受该药物以及该药物在治疗上是合适的。收集的数据包括过敏警报数量、忽略过敏警报的情况、忽略理由以及患者的人口统计学信息。使用描述性统计来总结结果。
当月录入的49,887条总医嘱中有643条（1.3%）触发了过敏警报（95%置信区间[CI]，1.2 - 1.4%）。共有289名患者触发了警报，每位患者平均有2条医嘱触发警报。年龄中位数为65岁。有医嘱触发警报的患者的住院时间中位数为三天。总体而言，643条警报中有625条（97%）因以下理由被忽略：患者先前耐受该药物（49%）、益处大于风险（29%）、该药物在治疗上是合适的（24%）以及自由文本解释（8%）。
虽然通过CPOE系统生成的一小部分处方医嘱触发了过敏警报，但大多数过敏警报被医生忽略。
