BMC Med Inform Decis Mak - Development of a context model to prioritize drug safety alerts in CPOE systems.

Tópicos

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Resumo

CKGROUND: Computerized physician order entry systems (CPOE) can reduce the number of medication errors and adverse drug events (ADEs) in healthcare institutions. Unfortunately, they tend to produce a large number of partly irrelevant alerts, in turn leading to alert overload and causing alert fatigue. The objective of this work is to identify factors that can be used to prioritize and present alerts depending on the 'context' of a clinical situation.METHODS: We used a combination of literature searches and expert interviews to identify and validate the possible context factors. The internal validation of the context factors was performed by calculating the inter-rater agreement of two researcher's classification of 33 relevant articles.RESULTS: We developed a context model containing 20 factors. We grouped these context factors into three categories: characteristics of the patient or case (e.g. clinical status of the patient); characteristics of the organizational unit or user (e.g. professional experience of the user); and alert characteristics (e.g. severity of the effect). The internal validation resulted in nearly perfect agreement (Cohen's Kappa value of 0.97).CONCLUSION: To our knowledge, this is the first structured attempt to develop a comprehensive context model for prioritizing drug safety alerts in CPOE systems. The outcome of this work can be used to develop future tailored drug safety alerting in CPOE systems.

Resumo Limpo

ckground computer physician order entri system cpoe can reduc number medic error advers drug event ade healthcar institut unfortun tend produc larg number part irrelev alert turn lead alert overload caus alert fatigu object work identifi factor can use priorit present alert depend context clinic situationmethod use combin literatur search expert interview identifi valid possibl context factor intern valid context factor perform calcul interrat agreement two research classif relev articlesresult develop context model contain factor group context factor three categori characterist patient case eg clinic status patient characterist organiz unit user eg profession experi user alert characterist eg sever effect intern valid result near perfect agreement cohen kappa valu conclus knowledg first structur attempt develop comprehens context model priorit drug safeti alert cpoe system outcom work can use develop futur tailor drug safeti alert cpoe system

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