Department of Pharmacy, Charle-Nicolle Hospital, 1006 Tunis, Tunisia.
College of Pharmacy, 5000 Monastir, Tunisia.
Ann Pharm Fr. 2022 Nov;80(6):819-826. doi: 10.1016/j.pharma.2022.05.002. Epub 2022 May 11.
Parenteral nutrition (PN) offers a quality therapeutic option when enteral feeding is non-tolerated or impossible. However, it can be associated with an increased risk of medical errors, especially in sensitive populations such as newborns. This study aimed at determining the impact of the implementation of a computerized physician order entry (CPOE) system on PN medication errors in the neonatology department in the largest teaching hospital in Tunisia.
The frequency of medication errors in PN, in a teaching neonatal intensive care unit, was prospectively reviewed by a pharmacist between December 2018 and March 2019 in a two-phase interventional study (pre and post locally developed CPOE System implementation).
Implementation of CPOE system decreased PN order errors from 379 to 147 representing a 61.1% reduction. The decreases on PN order errors per stage, i.e. prescribing and preparation, were form 207 to 22 (89.4%), and from 117 to 66 (43.6%), respectively. Mean nutrients intakes were in conformity to the recommended daily intakes during the CPOE phase of the study. CPOE is a protective tool against prescription and preparation errors. It significantly impacted all items of the ordering process.
In addition to the rigorous application of the recommendations, the CPOE system allows to reduce the risk of PN medication errors. This improves the safety and quality of medicines in newborns.
当肠内喂养不可耐受或不可能时，肠外营养（PN）提供了一种高质量的治疗选择。然而，它可能会增加医疗错误的风险，尤其是在新生儿等敏感人群中。本研究旨在确定在突尼斯最大的教学医院的新生儿科实施计算机化医嘱输入（CPOE）系统对 PN 药物错误的影响。
在一项两阶段干预研究（CPOE 系统实施前后）中，药剂师在 2018 年 12 月至 2019 年 3 月期间前瞻性地审查了教学新生儿重症监护病房中 PN 药物错误的频率。
CPOE 系统的实施将 PN 医嘱错误从 379 例减少到 147 例，减少了 61.1%。PN 医嘱错误在每个阶段（即处方和准备）的减少分别为从 207 例减少到 22 例（89.4%）和从 117 例减少到 66 例（43.6%）。研究的 CPOE 阶段，平均营养素摄入量符合推荐的每日摄入量。CPOE 是预防处方和准备错误的保护工具。它显著影响了医嘱过程的所有项目。
除了严格应用建议外，CPOE 系统还可以降低 PN 药物错误的风险。这提高了新生儿用药的安全性和质量。
