Use of Computerized Physician Order Entry with Clinical Decision Support to Prevent Dose Errors in Pediatric Medication Orders: A Systematic Review

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Xuất bản năm:Pediatric Drugs vol. 26, no. 2 (Mar 2024), p. 127
Tác giả chính: Ruutiainen, Henna
Tác giả khác: Holmström, Anna-Riia, Kunnola, Eva, Kuitunen, Sini
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Springer Nature B.V.
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100 1 |a Ruutiainen, Henna  |u Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, PL 56, 00014 Helsinki, Finland 
245 1 |a Use of Computerized Physician Order Entry with Clinical Decision Support to Prevent Dose Errors in Pediatric Medication Orders: A Systematic Review 
260 |b Springer Nature B.V.  |c Mar 2024 
513 |a Evidence Based Healthcare Journal Article 
520 3 |a Background 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 computerized physician order entry (CPOE) and clinical decision support (CDS) tools that assist safe prescribing. The objective of this study was to examine the effects of CPOE systems with CDS functions in preventing dose errors in pediatric medication orders.Material and Methods 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 PROSPERO (CRD42021277413). The final literature search on MEDLINE (Ovid), Scopus, Web of Science, and EMB Reviews was conducted on 10 September 2023. Only peer-reviewed studies considering both CPOE and CDS systems in pediatric inpatient or outpatient settings were included. Study selection, data extraction, and evidence quality assessment (IBI critical appraisal tool assessment and GRADE approach) were carried out by two individual reviewers. Vote counting method was used to evaluate the effects of CPOE-CDS systems on dose errors rates.Results 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 (11 = 8), and dosing frequency check (11 = 8). Alerts were recorded in 15 studies. A statistically significant reduction in dose errors was found in eight studies, whereas an increase of dose errors was not reported.Conclusions 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 human factors are still present within the medication use process, further studies and development activities are needed to optimize the usability of CPOE-CDS systems. 
653 |a Patients 
653 |a Clinical decision making 
653 |a Electronic health records 
653 |a Computerized physician order entry 
653 |a Pediatrics 
653 |a Prevention 
653 |a Systematic review 
653 |a Medical errors 
653 |a Drug dosages 
700 1 |a Holmström, Anna-Riia  |u Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, PL 56, 00014 Helsinki, Finland 
700 1 |a Kunnola, Eva  |u Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, PL 56, 00014 Helsinki, Finland 
700 1 |a Kuitunen, Sini  |u HUS Pharmacy, Helsinki University Hospital, Helsinki, Finland 
773 0 |t Pediatric Drugs  |g vol. 26, no. 2 (Mar 2024), p. 127 
786 0 |d ProQuest  |t Health & Medical Collection 
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