Wietholter Jon, Sitterson Susan, Allison Steven
West Virginia University, Morgantown, USA.
Am J Health Syst Pharm. 2009 Aug 1;66(15):1394-8. doi: 10.2146/ajhp080303.
The effect of computerized prescriber order entry (CPOE) on the efficiency of medication-order-processing time was evaluated.
This study was conducted at a 761-bed, tertiary care hospital. A total of 2988 medication orders were collected and analyzed before (n = 1488) and after CPOE implementation (n = 1500). Data analyzed included the time the prescriber ordered the medication, the time the pharmacy received the order, and the time the order was completed by a pharmacist.
The mean order-processing time before CPOE implementation was 115 minutes from prescriber composition to pharmacist verification. After CPOE implementation, the mean order-processing time was reduced to 3 minutes (p < 0.0001). The time that an order was received by the pharmacy to the time it was verified by a pharmacist was reduced from 31 minutes before CPOE implementation to 3 minutes after CPOE implementation (p < 0.0001). The implementation of CPOE reduced the order-processing time (from order composition to verification) by 97%. Additionally, pharmacy-specific order-processing time (from order receipt in the pharmacy to pharmacist verification) was reduced by 90%. This reduction in order-processing time improves patient care by shortening the interval between physician prescribing and medication availability and may allow pharmacists to explore opportunities for enhanced clinical activities that will further positively impact patient care.
CPOE implementation reduced the mean pharmacy order-processing time from composition to verification by 97%. After CPOE implementation, a new medication order was verified as appropriate by a pharmacist in three minutes, on average.
评估计算机化医嘱录入系统（CPOE）对医嘱处理时间效率的影响。
本研究在一家拥有761张床位的三级护理医院进行。共收集并分析了2988条医嘱，其中实施CPOE之前（n = 1488）和之后（n = 1500）各1488条。分析的数据包括开医嘱的时间、药房接收医嘱的时间以及药剂师完成医嘱的时间。
在实施CPOE之前，从开医嘱到药剂师审核的平均医嘱处理时间为115分钟。实施CPOE之后，平均医嘱处理时间缩短至3分钟（p < 0.0001）。药房接收医嘱到药剂师审核的时间从实施CPOE之前的31分钟缩短至实施CPOE之后的3分钟（p < 0.0001）。CPOE的实施使医嘱处理时间（从开医嘱到审核）缩短了97%。此外，药房特定的医嘱处理时间（从药房接收医嘱到药剂师审核）缩短了90%。医嘱处理时间的缩短通过缩短医生开医嘱与药物可用之间的间隔改善了患者护理，并可能使药剂师有机会探索加强临床活动的机会，这将进一步对患者护理产生积极影响。
CPOE的实施使药房从开医嘱到审核的平均医嘱处理时间缩短了97%。实施CPOE之后，新的医嘱平均在三分钟内就能被药剂师审核通过。
