Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients.

Tópicos

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Resumo

JECTIVE: This study evaluates the impact of 12,093 consecutive dose alerts generated by a computerized provider order entry system on pediatric medication ordering.PATIENTS AND METHODS: All medication orders entered and all resulting medication dose alerts at the Johns Hopkins Children's Medical and Surgical Center in 2010, were retrospectively evaluated. Inclusion criteria were hospitalized patients less than 21 years old. There were no exclusion criteria.RESULTS: During 2010, there were 7738 admissions for 5553 unique patients. A total of 182,308 medication orders for 1092 unique medications were submitted by providers. Six percent (11,155) of orders or order attempts generated alerts for 2046 patients and 524 medications. Two categories of alerts were analyzed: dose range alerts and informational alerts. 73.4% (8187) of all alerts were dose range alerts, with a compliance rate of 8.5% (694); 26.6% (2968) were informational alerts, with a compliance rate of 5.5% (163).CONCLUSIONS: We found that underdosing alerts provide less value to providers than overdosing alerts. However, the low compliance with the alerts should trigger the evaluation of clinical practice behavior and the existing alert thresholds. Informational alerts noting the absence of established dosing guidelines had little effect on provider behavior and should be avoided when building a dose range alert system.

Resumo Limpo

jectiv studi evalu impact consecut dose alert generat computer provid order entri system pediatr medic orderingpati method medic order enter result medic dose alert john hopkin children medic surgic center retrospect evalu inclus criteria hospit patient less year old exclus criteriaresult admiss uniqu patient total medic order uniqu medic submit provid six percent order order attempt generat alert patient medic two categori alert analyz dose rang alert inform alert alert dose rang alert complianc rate inform alert complianc rate conclus found underdos alert provid less valu provid overdos alert howev low complianc alert trigger evalu clinic practic behavior exist alert threshold inform alert note absenc establish dose guidelin littl effect provid behavior avoid build dose rang alert system

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