Journal of Medical Systems

, Volume 35, Issue 1, pp 25–37 | Cite as

The Effect of Computerized Physician Order Entry and Decision Support System on Medication Errors in the Neonatal Ward: Experiences from an Iranian Teaching Hospital

  • Alireza Kazemi
  • Johan Ellenius
  • Faramarz Pourasghar
  • Shahram Tofighi
  • Aref Salehi
  • Ali Amanati
  • Uno GH Fors
Original Paper

Abstract

Medication dosing errors are frequent in neonatal wards. In an Iranian neonatal ward, a 7.5 months study was designed in three periods to compare the effect of Computerized Physician Order Entry (CPOE) without and with decision support functionalities in reducing non-intercepted medication dosing errors in antibiotics and anticonvulsants. Before intervention (Period 1), error rate was 53%, which did not significantly change after the implementation of CPOE without decision support (Period 2). However, errors were significantly reduced to 34% after that the decision support was added to the CPOE (Period 3; P < 0.001). Dose errors were more often intercepted than frequency errors. Over-dose was the most frequent type of medication errors and curtailed-interval was the least. Transcription errors did not reduce after the CPOE implementation. Physicians ignored alerts when they could not understand why they appeared. A suggestion is to add explanations about these reasons to increase physicians’ compliance with the system’s recommendations.

Keywords

Medical order entry systems Decision support systems, clinical Medication errors Infant, newborn Patient safety Iran 

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Alireza Kazemi
    • 1
    • 2
    • 3
  • Johan Ellenius
    • 1
  • Faramarz Pourasghar
    • 1
  • Shahram Tofighi
    • 4
  • Aref Salehi
    • 5
  • Ali Amanati
    • 6
  • Uno GH Fors
    • 1
  1. 1.Department of Learning, Informatics, Management and Ethics (LIME)StockholmSweden
  2. 2.Management Information Systems CentreHamadan University of Medical SciencesHamadanIran
  3. 3.National Public Health Management Centre (NPMC)TabrizIran
  4. 4.School of Health Services Management and InformaticsIran University of Medical SciencesTehranIran
  5. 5.Department of CardiologyGorgan University of Medical SciencesGorganIran
  6. 6.Department of PaediatricsHamadan University of Medical SciencesHamadanIran

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