Prescribing is a high-risk task within the pediatric medication-use process and requires defenses to prevent errors. Such system-centric defenses include electronic health record systems with computer...
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria and Synthesis Without Meta-Analysis (SWiM) items. The study protocol was registered in...
A total of 17 studies published in 2007-2021 met the inclusion criteria. The most used CDS tools were dose range check (n = 14), dose calculator (n = 8), and dosing frequency check (n = 8). Alerts wer...
The CPOE-CDS systems have the potential to reduce pediatric dose errors. Most beneficial interventions seem to be system customization, implementing CDS alerts, and the use of dose range check. While ...
The purpose of this study was to develop a data-driven process to analyze barcode-assisted medication preparation alert data with a goal of minimizing inaccurate alerts....
Medication preparation data for the prior three-month period was obtained from an electronic health record system. A dashboard was developed to identify recurrent, high-volume alerts and associated me...
The institution averaged 31,000 medication preparation alerts per month. The "barcode not recognized" alert (13,000) was the highest volume over the study period. Eighty-five medication records were i...
This quality improvement project highlighted opportunities to improve medication purchasing, storage, and preparation through development of a standard process to evaluate barcode-assisted medication ...
The overall benefits of using clinical decision support systems (CDSSs) can be restrained if physicians inadvertently ignore clinically useful alerts due to "alert fatigue" caused by an excessive numb...
We conducted a retrospective study that evaluated MedGuard alerts, the alert acceptance rate, and the rate of LASA alerts between July 1, 2019, and June 31, 2021, from outpatient settings at an academ...
Over the two-year study period, 1,206,895 prescriptions were ordered and a total of 28,536 alerts were triggered (alert rate: 2.36 %). Of the 28,536 alerts presented to physicians, 13,947 (48.88 %) we...
This study shows that machine learning based CDSS, MedGuard, has an ability to improve patients' safety by triggering clinically valid alerts. This system can also help improve problem list documentat...
Knowledge of the prevalence and characteristics of medication errors in pediatric and neonatal patients is limited. This study aimed to evaluate the incidence and medication error characteristics in a...
We retrospectively reviewed medication errors documented between January 2015 and December 2019....
A total of 2,591,596 prescriptions were checked, and 255 errors were identified. Wrong dose prescriptions constituted the most common errors (56.9%). Medications with the highest rate of errors were a...
The incidence of medication errors decreased with extensive use of the CPOE system. Continuous application of the CPOE optimization program can effectively reduce medication errors. Further incorporat...
Clinical decision support systems (CDSSs) use alerts to enhance medication safety and reduce medication error rates. A major challenge of medication alerts is their low acceptance rate, limiting their...
In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, a literature search in PubMed was started in February 2018 and continued until October 202...
Out of 539 articles, 60 were included. A total of 391 single parameters were extracted (e.g., patients' comorbidity) and grouped into 75 factors (e.g., comorbidity), and 25 determinants (e.g., complex...
This review compiles modulators of alert acceptance distinguished by being studied quantitatively or qualitatively and indicates their effect magnitude whenever possible. Additionally, it describes ho...
Pseudorandomized testing can be applied to perform rigorous yet practical evaluations of clinical decision support tools. We apply this methodology to an interruptive alert aimed at reducing free-text...
The objective of this study is to evaluate the effectiveness of an interruptive alert at reducing free-text prescriptions via pseudorandomized testing using native electronic health records (EHR) func...
Two versions of an EHR alert triggered when a provider attempted to sign a discharge free-text prescription. The visible version displayed an interruptive alert to the user, and a silent version trigg...
Over the 28-week study period, 143 providers triggered 695 alerts (345 visible and 350 silent). The proportions of encounters with free-text prescriptions were 83% (266/320) and 90% (273/303) in the i...
An interruptive alert was associated with a modest reduction in free-text prescriptions. Furthermore, the majority of these prescriptions could have been reproduced using structured order entry fields...
To determine whether hospital computerised physician order entry (CPOE) systems contribute to securing intravenous potassium chloride (KCl) prescriptions with reference to the recommendations issued b...
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 withou...
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 medicatio...
The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests ...
Cross sectional study at the Emergency Department of Hospital Italiano de Buenos Aires, which included a consecutive sample of pre-intervention (January-February 2020) and post-intervention (2021) con...
There were 27,671 consultations in 2020 with a total median value of $474, and 20,819 with $1,639 in 2021. After the analysis restricted to the area of moderately complex clinics (excluding COVID-19...
Despite inflation, a significant reduction in the number of practices was achieved and overall costs per consultation were maintained. These findings demonstrate the effectiveness of the intervention,...
To evaluate the potential of a novel system using outlier detection screening algorithms and to identify medication related risks in an inpatient setting....
In the first phase of the study, we evaluated the transferability of models refined at another medical center using a different electronic medical record system (EMR) on 3 years of historical data (20...
In the retrospective phase of the study, 226,804 medical orders were analyzed, generating a total of 2731 alerts (1.2% of medical orders). Of the alerts analyzed, 69% were clinically relevant alerts a...
In an inpatient setting of a 600 bed computerized decision support system (CDSS) -naïve medical center, the system generated accurate and clinically valid alerts with low alert burden enabling physici...
