Rzewnicki Daniel, Kanvinde Atul, Gillespie Scott, Orenstein Evan
Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, United States.
Information Technology, Shepherd Center, Atlanta, GA 30305, United States.
JAMIA Open. 2024 Jul 2;7(3):ooae042. doi: 10.1093/jamiaopen/ooae042. eCollection 2024 Oct.
Wrong-patient order entry (WPOE) is a potentially dangerous medical error. It remains unknown if patient photographs reduce WPOE in the pediatric inpatient population.
Order sessions from a single pediatric hospital system were examined for retract-and-reorder (RAR) events, a surrogate WPOE measure. We determined the association of patient photographs with the proportion of order sessions resulting in a RAR event, adjusted for patient, provider, and ordering context.
In multivariable analysis, the presence of a patient photo in the electronic health record was associated with 40% lower odds of a RAR event (aOR: 0.60, 95% CI: 0.48-0.75), while cardiac and ICU contexts had higher RAR frequency (aOR: 2.12, 95% CI: 1.69-2.67 and 2.05, 95% CI: 1.71-2.45, respectively).
Patient photos were associated with lower odds of RAR events in the pediatric inpatient setting, while high acuity locations may be at higher risk. Patient photographs may reduce WPOE without interruptions.
错误患者医嘱录入(WPOE)是一种潜在危险的医疗差错。患者照片是否能减少儿科住院患者中的WPOE尚不清楚。
对单一儿科医院系统的医嘱录入环节进行检查,以查找撤回并重新录入(RAR)事件,这是一种替代WPOE的衡量指标。我们确定了患者照片与导致RAR事件的医嘱录入环节比例之间的关联,并对患者、医护人员和医嘱录入背景进行了调整。
在多变量分析中,电子健康记录中存在患者照片与RAR事件发生几率降低40%相关(调整后比值比:0.60,95%置信区间:0.48 - 0.75),而心脏科和重症监护室环境下RAR事件发生频率较高(调整后比值比分别为:2.12,95%置信区间:1.69 - 2.67;2.05,95%置信区间:1.71 - 2.45)。
在儿科住院环境中,患者照片与RAR事件发生几率较低相关,而高急症程度的科室可能风险更高。患者照片可能会减少WPOE且不会造成干扰。