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- Title
Reduction in chemotherapy order errors with computerised physician order entry and clinical decision support systems.
- Authors
Aziz, Muhammad Tahir; Ur-Rehman, Tofeeq; Qureshi, Sadia; Bukhari, Nadeem Irfan
- Abstract
Background: Medication errors in chemotherapy are frequent and lead to patient morbidity and mortality, as well as increased rates of re-admission and length of stay, and considerable extra costs. Objective: This study investigated the proposition that computerised chemotherapy ordering reduces the incidence and severity of chemotherapy protocol errors. Method: A computerised physician order entry of chemotherapy order (C-CO) with clinical decision support system was developed in-house, including standardised chemotherapy protocol definitions, automation of pharmacy distribution, clinical checks, labeling and invoicing. A prospective study was then conducted in a C-CO versus paper based chemotherapy order (P-CO) in a 30-bed chemotherapy bay of a tertiary hospital. Both C-CO and P-CO orders, including pharmacoeconomic analysis and the severity of medication errors, were checked and validated by a clinical pharmacist. A group analysis and field trial were also conducted to assess clarity, feasibility and decision making. Results and Conclusion: The C-CO was very usable in terms of its clarity and feasibility. The incidence of medication errors was significantly lower in the C-CO compared with the P-CO (10/3765 [0.26%] versus 134/5514 [2.4%]). There was also a reduction in dispensing time of chemotherapy protocols in the C-CO. The chemotherapy computerisation with clinical decision support system resulted in a significant decrease in the occurrence and severity of medication errors, improvements in chemotherapy dispensing and administration times, and reduction of chemotherapy cost.
- Subjects
PAKISTAN; MEDICATION error prevention; CANCER chemotherapy; COMPARATIVE studies; DECISION support systems; INFORMATION storage & retrieval systems; MEDICAL databases; LONGITUDINAL method; MEDICATION errors; QUESTIONNAIRES; SCALE analysis (Psychology); SYSTEMS design; WORK measurement; WRITING; DISEASE incidence; CROSS-sectional method; DESCRIPTIVE statistics
- Publication
Health Information Management Journal, 2015, Vol 44, Issue 3, p13
- ISSN
1833-3583
- Publication type
Academic Journal
- DOI
10.1177/183335831504400303