计算机化化疗医嘱录入的经验。
Experience with computerized chemotherapy order entry.
机构信息
Division of Gynecologic Oncology, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY.
出版信息
J Oncol Pract. 2006 Mar;2(2):49-52. doi: 10.1200/JOP.2006.2.2.49.
PURPOSE
The elimination of errors related to chemotherapy administration remains an elusive goal. Computerized order entry has been shown to reduce errors. We assessed a chemotherapy computer order entry system for errors related to dosing and for the time required to prepare chemotherapy orders.
METHODS
A prospective study of all patients treated with chemotherapy over a 12-month period was performed. Chemotherapy order sets done via computerized order entry were reviewed for errors related to drug selection, dose calculations, decimal-point errors, and for exceeding a warning level set within the system. We also measured the time required to produce three order sets by hand versus by computer.
RESULTS
There were no errors in dose calculations, decimal points, or drug selection for 2,558 drug administrations in 235 patients treated with 26 different chemotherapy regimens. The dose warning level was exceeded in 152 (6%) of drug administrations, but never without user permission to override the warning. The average time saved per order set using computer order entry was 10 minutes (P < .05).
CONCLUSION
By using computer order entry with error-checking algorithms, it may be possible to eliminate a number of types of errors associated with chemotherapy administration without sacrificing efficiency.
目的
消除与化疗给药相关的错误仍然是一个难以实现的目标。计算机医嘱录入已被证明可以减少错误。我们评估了化疗计算机医嘱录入系统，以评估其在剂量相关错误和准备化疗医嘱所需时间方面的表现。
方法
对 12 个月内接受化疗治疗的所有患者进行了前瞻性研究。通过计算机医嘱录入完成的化疗医嘱集，评估了药物选择、剂量计算、小数点错误以及超出系统设定警告水平的错误。我们还测量了通过手工和计算机生成三个医嘱集所需的时间。
结果
在 235 名接受 26 种不同化疗方案治疗的患者的 2558 次药物给药中，剂量计算、小数点或药物选择均无错误。在 152 次（6%）药物给药中超过了剂量警告水平，但均经用户许可覆盖了警告。使用计算机医嘱录入，每个医嘱集平均节省 10 分钟时间（P<.05）。
结论
通过使用带有错误检查算法的计算机医嘱录入，在不降低效率的情况下，可能可以消除与化疗给药相关的许多类型的错误。
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