[Inability of hospital computerised physician order entry systems to secure the use of concentrated potassium intravenous solutions].

To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued by French healthcare agencies. We sent a questionnaire to the members of the Association pour le Digital et l'Information en Pharmacie. More than three quarters of the 84 responses received involving 23 CPOE systems indicate that it is possible to : prescribe an ampoule of concentrated potassium chloride 10% 10 mL intravenously without any diluent (80 %); prescribe 4 grams of KCl in a bag of 500 mL of NaCl 0,9% (98 %); prescribe a solution that contains 6 grams of KCl per liter (94 %); prescribe the administration of an injectable ampoule orally by means of a free text comment (83 %). Nearly half of the responses indicate that it is possible to prescribe: concentrated KCl ampouSles as administration solvent (50 %); an injectable vial to be administered by oral route (52 %). At least 23 hospital CPOE systems are unable to secure the prescriptions of injectable KCl. This finding lifts the veil on an unthought, namely the role of CPOE systems in securing high-risk medications. In order to solve this problem, it should be mandatory that health information technology vendors pay particular attention to these drugs. With regard to injectable KCl, the utilisation of a dilution vehicule, maximum concentration and maximum infusion flow rate are the first four constraints to be satisfied.

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