Author/Authors :
Khammarnia, Mohammad Health Promotion Research Center - Zahedan University of Medical Sciences, Zahedan, Iran , Sharifian, Roxana Department of Health Information Management - School of Management and Medical Information Sciences - Health Human Resources Research Center - Shiraz University of Medical Sciences, Shiraz, Iran , Zand, Farid Shiraz Anesthesiology and Critical Care Research Center - Department of Anesthesia and Critical Care Medicine - Shiraz University of Medical Sciences, Shiraz, Iran , Barati, Omid Department of Health Care Management - School of Management and Medical Information - Shiraz University of Medical Sciences, Shiraz, Iran , Keshtkaran, Ali Department of Health Care Management - School of Management and Medical Information - Shiraz University of Medical Sciences, Shiraz, Iran , Sabetian, Golnar Trauma Research Center - Shiraz University of Medical Sciences, Shiraz, Iran , Shahrokh, Nasim Student Research Committee - Shiraz University of Medical Sciences, Shiraz, Iran , Setoodezadeh, Fatemeh Health Promotion Research Center - Zahedan University of Medical Sciences, Zahedan, Iran
Abstract :
Background: One way to reduce medical errors associated with physician orders is computerized physician order entry (CPOE)
software. This study was conducted to compare prescription orders between 2 groups before and after CPOE implementation in a hospital.
Methods: We conducted a before-after prospective study in 2 intensive care unit (ICU) wards (as intervention and control wards) in
the largest tertiary public hospital in South of Iran during 2014 and 2016. All prescription orders were validated by a clinical pharmacist
and an ICU physician. The rates of ordering the errors in medical orders were compared before (manual ordering) and after implementation
of the CPOE. A standard checklist was used for data collection. For the data analysis, SPSS Version 21, descriptive statistics,
and analytical tests such as McNemar, chi-square, and logistic regression were used.
Results: The CPOE significantly decreased 2 types of errors, illegible orders and lack of writing the drug form, in the intervention
ward compared to the control ward (p< 0.05); however, the 2 errors increased due to the defect in the CPOE (p< 0.001). The use of
CPOE decreased the prescription errors from 19% to 3% (p= 0.001), However, no differences were observed in the control ward
(p<0.05). In addition, more errors occurred in the morning shift (p< 0.001).
Conclusion: In general, the use of CPOE significantly reduced the prescription errors. Nonetheless, more caution should be exercised
in the use of this system, and its deficiencies should be resolved. Furthermore, it is recommended that CPOE be used to improve
the quality of delivered services in hospitals.
