Title | ||
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A systematic review of the types and causes of prescribing errors generated from using computerized provider order entry systems in primary and secondary care. |
Abstract | ||
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Objective: To understand the different types and causes of prescribing errors associated with computerized provider order entry (CPOE) systems, and recommend improvements in these systems. Materials and Methods: We conducted a systematic review of the literature published between January 2004 and June 2015 using three large databases: the Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline. Studies that reported qualitative data about the types and causes of these errors were included. A narrative synthesis of all eligible studies was undertaken. Results: A total of 1185 publications were identified, of which 34 were included in the review. We identified 8 key themes associated with CPOE-related prescribing errors: computer screen display, drop-down menus and autopopulation, wording, default settings, nonintuitive or inflexible ordering, repeat prescriptions and automated processes, users' work processes, and clinical decision support systems. Displaying an incomplete list of a patient's medications on the computer screen often contributed to prescribing errors. Lack of system flexibility resulted in users employing error-prone workarounds, such as the addition of contradictory free-text comments. Users' misinterpretations of how text was presented in CPOE systems were also linked with the occurrence of prescribing errors. Discussion and Conclusions: Human factors design is important to reduce error rates. Drop-down menus should be designed with safeguards to decrease the likelihood of selection errors. Development of more sophisticated clinical decision support, which can perform checks on free-text, may also prevent errors. Further research is needed to ensure that systems minimize error likelihood and meet users' workflow expectations. |
Year | DOI | Venue |
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2016 | 10.1093/jamia/ocw119 | JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION |
Keywords | DocType | Volume |
computerized provider order entry,clinical decision support,alerts,medication errors,patient safety,decision-making | Conference | 24 |
Issue | ISSN | Citations |
2 | 1067-5027 | 1 |
PageRank | References | Authors |
0.48 | 16 | 9 |
Name | Order | Citations | PageRank |
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Clare L Brown | 1 | 1 | 0.48 |
Helen L Mulcaster | 2 | 1 | 0.48 |
Katherine L Triffitt | 3 | 1 | 0.48 |
Dean F. Sittig | 4 | 1038 | 163.51 |
Joan S Ash | 5 | 1 | 0.48 |
Katie Reygate | 6 | 1 | 0.48 |
Andrew K Husband | 7 | 2 | 0.85 |
David W Bates | 8 | 1 | 0.48 |
Sarah P Slight | 9 | 67 | 19.57 |