Int J Med Inform - Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow.

Tópicos

{ time(1939) patient(1703) rate(768) }
{ medic(1828) order(1363) alert(1069) }
{ care(1570) inform(1187) nurs(1089) }
{ perform(999) metric(946) measur(919) }
{ record(1888) medic(1808) patient(1693) }
{ patient(2837) hospit(1953) medic(668) }
{ ehr(2073) health(1662) electron(1139) }
{ group(2977) signific(1463) compar(1072) }
{ cancer(2502) breast(956) screen(824) }
{ chang(1828) time(1643) increas(1301) }
{ use(2086) technolog(871) perceiv(783) }
{ studi(1119) effect(1106) posit(819) }
{ first(2504) two(1366) second(1323) }
{ use(1733) differ(960) four(931) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ treatment(1704) effect(941) patient(846) }
{ design(1359) user(1324) use(1319) }
{ data(3963) clinic(1234) research(1004) }
{ system(1050) medic(1026) inform(1018) }
{ visual(1396) interact(850) tool(830) }
{ perform(1367) use(1326) method(1137) }
{ age(1611) year(1155) adult(843) }
{ intervent(3218) particip(2042) group(1664) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ research(1085) discuss(1038) issu(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ estim(2440) model(1874) function(577) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: The study objective was to determine if computerized provider order entry (CPOE) systems impaired or enhanced workflow in the neonatal intensive care unit (NICU) by comparing the timing of administration of the first dose of antibiotics before and after CPOE system implementation.METHODS: We conducted a pre-post intervention comparative study of the length of time between admission and administration of initial antibiotics in neonates before and after a CPOE system was implemented. Clinical information and timing of antibiotic administration were collected on all inborn infants, who were admitted to the NICU in the first 4h of life and treated with antibiotics, for one year prior to the implementation of computerized order entry and for one year after the implementation.RESULTS: Infants admitted to the NICU were similar in both periods (mean birth weight 2183 g vs. 2091 g, gestational age 33.3 weeks vs. 33.0 weeks). There was no significant difference in mean length of time from admission to antibiotic administration in the pre-CPOE group (131 min [CI 124-139]) compared to the post-CPOE group (125 min [CI 116-133]) (p=0.07). The mean time to pharmacy verification for a subset of patients was significantly shorter for patients in the post-CPOE group (61 ? 58 min) compared to the pre-CPOE group (88 ? 76 min) (p=<0.001).CONCLUSIONS: While the introduction of a CPOE system in the NICU did not significantly improve antibiotic administration times, the timeliness of an important aspect of the medication process, time to pharmacy verification, was improved. These findings imply other factors are impeding workflow. Further studies are needed to evaluate how CPOE systems combined with patient care activities affect workflow and overall patient care.

Resumo Limpo

jectiv studi object determin computer provid order entri cpoe system impair enhanc workflow neonat intens care unit nicu compar time administr first dose antibiot cpoe system implementationmethod conduct prepost intervent compar studi length time admiss administr initi antibiot neonat cpoe system implement clinic inform time antibiot administr collect inborn infant admit nicu first h life treat antibiot one year prior implement computer order entri one year implementationresult infant admit nicu similar period mean birth weight g vs g gestat age week vs week signific differ mean length time admiss antibiot administr precpo group min ci compar postcpo group min ci p mean time pharmaci verif subset patient signific shorter patient postcpo group min compar precpo group min pconclus introduct cpoe system nicu signific improv antibiot administr time timeli import aspect medic process time pharmaci verif improv find impli factor imped workflow studi need evalu cpoe system combin patient care activ affect workflow overal patient care

Resumos Similares

J Am Med Inform Assoc - Early cost and safety benefits of an inpatient electronic health record. ( 0,786085539987797 )
Telemed J E Health - Robotic telepresence versus standardly supervised stroke alert team assessments. ( 0,762900514757271 )
Int J Med Inform - Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. ( 0,758535865220109 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,746993835384148 )
J. Med. Internet Res. - An analysis of online evaluations on a physician rating website: evidence from a German public reporting instrument. ( 0,746360220721387 )
Int J Med Inform - Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: a randomized clinical trial. ( 0,727736445169651 )
Med Decis Making - Patient time costs associated with sensor-augmented insulin pump therapy for type 1 diabetes: results from the STAR 3 randomized trial. ( 0,705420395676318 )
Int J Med Inform - Effects of electronic medical record in a Chinese hospital: a time series study. ( 0,701584593194631 )
J Telemed Telecare - Using telemonitoring to construct knowledge about homebound patient populations: vital-signs alert rates. ( 0,693722800844206 )
J. Med. Internet Res. - Online social network use by health care providers in a high traffic patient care environment. ( 0,693398689772797 )
J Telemed Telecare - Evaluation of a telemedical care programme for patients with Parkinson's disease. ( 0,686013291733086 )
Telemed J E Health - Telephotography in trauma: a 2-year clinical experience. ( 0,676152221890161 )
Int J Med Inform - Effects of a short text message reminder system on emergency department length of stay. ( 0,675048989380004 )
J. Med. Internet Res. - Clinical outcome and cost-effectiveness of a synchronous telehealth service for seniors and nonseniors with cardiovascular diseases: quasi-experimental study. ( 0,673711860828512 )
Appl Clin Inform - A Computerized Alert Screening for Severe Sepsis in Emergency Department Patients Increases Lactate Testing but does not Improve Inpatient Mortality. ( 0,672002924563092 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,66053478614225 )
J Am Med Inform Assoc - A novel clinician interface to improve clinician access to up-to-date genetic results. ( 0,657827156315338 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,656968775170893 )
Comput Methods Programs Biomed - A guideline-based decision support for pharmacological treatment can improve the quality of hyperlipidemia management. ( 0,65333597003883 )
Int J Med Inform - Prospective pilot study of a tablet computer in an Emergency Department. ( 0,652032348609048 )
J Am Med Inform Assoc - Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool. ( 0,647533639460442 )
Telemed J E Health - Improved access and cycle time with an in-house patient-centered teleglaucoma program versus traditional in-person assessment. ( 0,6414566350342 )
Healthc (Amst) - Effects of implementing a protocol for arterial blood gas use on ordering practices and diagnostic yield. ( 0,641339376446238 )
J Am Med Inform Assoc - Effectiveness of an automated surveillance system for intensive care unit-acquired infections. ( 0,635433463488439 )
J. Med. Internet Res. - Online doctor reviews: do they track surgeon volume, a proxy for quality of care? ( 0,635170096638101 )
Int J Med Inform - Does the introduction of an electronic nursing documentation system in a nursing home reduce time on documentation for the nursing staff? ( 0,635000641441938 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,634692124047249 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,634043142554379 )
J Med Syst - Variability of subspecialty-specific anesthesia-controlled times at two academic institutions. ( 0,633029525072108 )
Telemed J E Health - Emergency department physician telemedical triage. ( 0,630520083743524 )
J Telemed Telecare - Utilization of home telemonitoring in patients 75 years of age and over with complex heart failure. ( 0,629594044333674 )
J Telemed Telecare - Telemedicine-supported insulin optimisation in primary care. ( 0,628578904574318 )
J Am Med Inform Assoc - Use of electronic clinical documentation: time spent and team interactions. ( 0,627533016213962 )
J Telemed Telecare - A longitudinal study of health service utilization for diabetes patients in a care coordination home-telehealth programme. ( 0,623322909369572 )
J. Med. Internet Res. - Web-based cognitive training: patient adherence and intensity of treatment in an outpatient memory clinic. ( 0,62293177450715 )
Telemed J E Health - Detection of asymptomatic paroxysmal atrial fibrillation with the trans-telephonic electrocardiograph system. ( 0,622601307059583 )
Med Biol Eng Comput - Strategy for NSAID administration to aspirin-intolerant asthmatics in combination with PGE2 analogue: a theoretical approach. ( 0,621301054709329 )
BMC Med Inform Decis Mak - Implementation and evaluation of a nurse-centered computerized potassium regulation protocol in the intensive care unit--a before and after analysis. ( 0,616265466251185 )
J Telemed Telecare - A hybrid approach to telepathology in Cambodia. ( 0,615259528889854 )
J Clin Monit Comput - Impact of non invasive and beat-to-beat arterial pressure monitoring on intraoperative hemodynamic management. ( 0,614632734772215 )
Telemed J E Health - Communication strategies and timeliness of response to life critical telemetry alarms. ( 0,613804524391639 )
J Clin Monit Comput - The effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia. ( 0,610467591835719 )
Perspect Health Inf Manag - Electronic prescribing: improving the efficiency and accuracy of prescribing in the ambulatory care setting. ( 0,608991613352875 )
Healthc (Amst) - Use of patient ethnography to support quality improvement in benign prostatic hyperplasia. ( 0,605136282674718 )
Int J Med Inform - The positive financial impact of using an Intensive Care Information System in a tertiary Intensive Care Unit. ( 0,604165083490576 )
Appl Clin Inform - An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV. ( 0,602347871732894 )
Appl Clin Inform - Introduction of electronic referral from community associated with more timely review by secondary services. ( 0,600138745102917 )
Appl Clin Inform - Effects of automated immunization registry reporting via an electronic health record deployed in community practice settings. ( 0,599370099794198 )
J Am Med Inform Assoc - Clinical decision support for atypical orders: detection and warning of atypical medication orders submitted to a computerized provider order entry system. ( 0,59742809546828 )
Telemed J E Health - Is telemedicine an answer to reducing 30-day readmission rates post-acute myocardial infarction? ( 0,596797188591699 )
Appl Clin Inform - Evaluating the impact of the electronic health record on patient flow in a pediatric emergency department. ( 0,595498460709443 )
J Telemed Telecare - A pilot trial of telemedicine-assisted, integrated care for patients with advanced amyotrophic lateral sclerosis and their caregivers. ( 0,594491037229037 )
Med Decis Making - Time lost by driving fast in the United States. ( 0,593985140290233 )
J Am Med Inform Assoc - A long-term follow-up evaluation of electronic health record prescribing safety. ( 0,593627345053782 )
Comput. Biol. Med. - Recurring patterns of atrial fibrillation in surface ECG predict restoration of sinus rhythm by catheter ablation. ( 0,592457354537768 )
J Am Med Inform Assoc - Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes. ( 0,591911906758908 )
J Telemed Telecare - User engagement with and attitudes towards an interactive SMS reminder system for patients with tuberculosis. ( 0,591419514330503 )
Int J Med Inform - Prescribers' interactions with medication alerts at the point of prescribing: A multi-method, in situ investigation of the human-computer interaction. ( 0,590954501014808 )
J Am Med Inform Assoc - Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals. ( 0,589680762576923 )
Int J Med Robot - Novel computer-assisted preoperative planning system for humeral shaft fractures: report of 43 cases. ( 0,589624316884277 )
J Telemed Telecare - A telepsychiatry transition clinic: the first 12 months experience. ( 0,589480129266993 )
Int J Med Robot - Comparison of the initial surgical experience with robotic and laparoscopic myomectomy. ( 0,588702925306947 )
J Am Med Inform Assoc - Effectiveness of an information technology intervention to improve prophylactic antibacterial use in the postoperative period. ( 0,585665463233972 )
Telemed J E Health - Hot spot: impact of July 2011 heat wave in southern Italy (Apulia) on cardiovascular disease assessed by emergency medical service and telemedicine support. ( 0,585631560985407 )
J Telemed Telecare - A pilot study of a tool to stimulate physical activity in patients with COPD or type 2 diabetes in primary care. ( 0,585463884858498 )
J. Med. Internet Res. - Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data. ( 0,58502527903983 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,584905792801702 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,584469887732662 )
AMIA Annu Symp Proc - A real-time screening alert improves patient recruitment efficiency. ( 0,583281727145431 )
Int J Med Inform - Adoption of a clinical decision support system to promote judicious use of antibiotics for acute respiratory infections in primary care. ( 0,582279088731935 )
Health Informatics J - Effects of a computerized decision support system in improving pharmacological management in high-risk cardiovascular patients: A cluster-randomized open-label controlled trial. ( 0,582220174090174 )
Appl Clin Inform - Healthcare Information Systems to Assess Influenza Outbreaks: An analysis of the 2009 H1N1 Epidemic in Buenos Aires. ( 0,577888609056554 )
BMC Med Inform Decis Mak - Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents. ( 0,577822828161548 )
J Am Med Inform Assoc - Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy. ( 0,577530679573004 )
Appl Clin Inform - Use of clinical decision support to improve the quality of care provided to older hospitalized patients. ( 0,57675804103692 )
J. Med. Internet Res. - Daily collection of self-reporting sleep disturbance data via a smartphone app in breast cancer patients receiving chemotherapy: a feasibility study. ( 0,576284893305772 )
J Med Syst - A novel medium access control protocol with low delay and traffic adaptivity for wireless body area networks. ( 0,575514576244189 )
J Telemed Telecare - Non-response in telephone surveys of COPD patients does not introduce bias. ( 0,575314657775757 )
J Am Med Inform Assoc - Patient reported barriers to enrolling in a patient portal. ( 0,575307839320096 )
BMC Med Inform Decis Mak - Impact of computerized physician order entry (CPOE) system on the outcome of critically ill adult patients: a before-after study. ( 0,573988427219387 )
J Med Syst - Perceived usefulness of data entry tools in medical encounters: a survey. ( 0,571097041413305 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,570615925258613 )
J Telemed Telecare - Suitability of an electronic reminder device for measuring drug adherence in elderly patients with complex medication. ( 0,570317618098224 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,567141192948916 )
Int J Neural Syst - Cortical excitability and refractory epilepsy: a three-year longitudinal transcranial magnetic stimulation study. ( 0,565923706896048 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,56487585187674 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,563968869597475 )
J Clin Monit Comput - Noninvasive assessment of peripheral microcirculation by near-infrared spectroscopy: a comparative study in healthy smoking and nonsmoking volunteers. ( 0,562553053252706 )
J. Med. Internet Res. - Diabetes patients' experiences with the implementation of insulin therapy and their perceptions of computer-assisted self-management systems for insulin therapy. ( 0,562275721289095 )
J. Med. Internet Res. - Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study. ( 0,562112634613749 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,560381683803822 )
Comput Methods Programs Biomed - Influenza vaccination and reduction in risk of ischemic heart disease among chronic obstructive pulmonary elderly. ( 0,560119207743813 )
Int J Med Inform - Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation. ( 0,559832635983263 )
Healthc (Amst) - Time spent with patients by physicians, nurse practitioners, and physician assistants in community health centers, 2006-2010. ( 0,558983649989446 )
J Am Med Inform Assoc - Impact of an electronic medication management system on hospital doctors' and nurses' work: a controlled pre-post, time and motion study. ( 0,558618069150905 )
J. Med. Internet Res. - Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease. ( 0,557396244931134 )
Int J Med Robot - Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery. ( 0,557221492467169 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,556840946963072 )
Appl Clin Inform - Decay of references to Web sites in articles published in general medical journals: mainstream vs small journals. ( 0,556024855296571 )
J Clin Monit Comput - Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation. ( 0,555669767022439 )