Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system

Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study w...
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Autor*in:	Aude Motulsky [verfasserIn] Tibor Schuster [verfasserIn] Philippe Jouvet [verfasserIn] Denis Lebel [verfasserIn] Man Qing Liang [verfasserIn] Maxime Thibault [verfasserIn] Marie-Pierre Moreault [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Übergeordnetes Werk:	In: BMJ Health & Care Informatics - BMJ Publishing Group, 2019, 30(2023), 1
Übergeordnetes Werk:	volume:30 ; year:2023 ; number:1

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1136/bmjhci-2022-100622

Katalog-ID:	DOAJ086261053

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520			\|a Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.
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allfields	10.1136/bmjhci-2022-100622 doi (DE-627)DOAJ086261053 (DE-599)DOAJ7e5d1fa8e43f4666a3a1b7f08269a4f3 DE-627 ger DE-627 rakwb eng R858-859.7 Aude Motulsky verfasserin aut Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety. Computer applications to medicine. Medical informatics Tibor Schuster verfasserin aut Philippe Jouvet verfasserin aut Denis Lebel verfasserin aut Man Qing Liang verfasserin aut Maxime Thibault verfasserin aut Marie-Pierre Moreault verfasserin aut In BMJ Health & Care Informatics BMJ Publishing Group, 2019 30(2023), 1 (DE-627)1685156673 (DE-600)3003028-6 26321009 nnns volume:30 year:2023 number:1 https://doi.org/10.1136/bmjhci-2022-100622 kostenfrei https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 kostenfrei https://informatics.bmj.com/content/30/1/e100622.full kostenfrei https://doaj.org/toc/2632-1009 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 30 2023 1
spelling	10.1136/bmjhci-2022-100622 doi (DE-627)DOAJ086261053 (DE-599)DOAJ7e5d1fa8e43f4666a3a1b7f08269a4f3 DE-627 ger DE-627 rakwb eng R858-859.7 Aude Motulsky verfasserin aut Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety. Computer applications to medicine. Medical informatics Tibor Schuster verfasserin aut Philippe Jouvet verfasserin aut Denis Lebel verfasserin aut Man Qing Liang verfasserin aut Maxime Thibault verfasserin aut Marie-Pierre Moreault verfasserin aut In BMJ Health & Care Informatics BMJ Publishing Group, 2019 30(2023), 1 (DE-627)1685156673 (DE-600)3003028-6 26321009 nnns volume:30 year:2023 number:1 https://doi.org/10.1136/bmjhci-2022-100622 kostenfrei https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 kostenfrei https://informatics.bmj.com/content/30/1/e100622.full kostenfrei https://doaj.org/toc/2632-1009 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 30 2023 1
allfields_unstemmed	10.1136/bmjhci-2022-100622 doi (DE-627)DOAJ086261053 (DE-599)DOAJ7e5d1fa8e43f4666a3a1b7f08269a4f3 DE-627 ger DE-627 rakwb eng R858-859.7 Aude Motulsky verfasserin aut Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety. Computer applications to medicine. Medical informatics Tibor Schuster verfasserin aut Philippe Jouvet verfasserin aut Denis Lebel verfasserin aut Man Qing Liang verfasserin aut Maxime Thibault verfasserin aut Marie-Pierre Moreault verfasserin aut In BMJ Health & Care Informatics BMJ Publishing Group, 2019 30(2023), 1 (DE-627)1685156673 (DE-600)3003028-6 26321009 nnns volume:30 year:2023 number:1 https://doi.org/10.1136/bmjhci-2022-100622 kostenfrei https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 kostenfrei https://informatics.bmj.com/content/30/1/e100622.full kostenfrei https://doaj.org/toc/2632-1009 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 30 2023 1
allfieldsGer	10.1136/bmjhci-2022-100622 doi (DE-627)DOAJ086261053 (DE-599)DOAJ7e5d1fa8e43f4666a3a1b7f08269a4f3 DE-627 ger DE-627 rakwb eng R858-859.7 Aude Motulsky verfasserin aut Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety. Computer applications to medicine. Medical informatics Tibor Schuster verfasserin aut Philippe Jouvet verfasserin aut Denis Lebel verfasserin aut Man Qing Liang verfasserin aut Maxime Thibault verfasserin aut Marie-Pierre Moreault verfasserin aut In BMJ Health & Care Informatics BMJ Publishing Group, 2019 30(2023), 1 (DE-627)1685156673 (DE-600)3003028-6 26321009 nnns volume:30 year:2023 number:1 https://doi.org/10.1136/bmjhci-2022-100622 kostenfrei https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 kostenfrei https://informatics.bmj.com/content/30/1/e100622.full kostenfrei https://doaj.org/toc/2632-1009 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 30 2023 1
allfieldsSound	10.1136/bmjhci-2022-100622 doi (DE-627)DOAJ086261053 (DE-599)DOAJ7e5d1fa8e43f4666a3a1b7f08269a4f3 DE-627 ger DE-627 rakwb eng R858-859.7 Aude Motulsky verfasserin aut Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety. Computer applications to medicine. Medical informatics Tibor Schuster verfasserin aut Philippe Jouvet verfasserin aut Denis Lebel verfasserin aut Man Qing Liang verfasserin aut Maxime Thibault verfasserin aut Marie-Pierre Moreault verfasserin aut In BMJ Health & Care Informatics BMJ Publishing Group, 2019 30(2023), 1 (DE-627)1685156673 (DE-600)3003028-6 26321009 nnns volume:30 year:2023 number:1 https://doi.org/10.1136/bmjhci-2022-100622 kostenfrei https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 kostenfrei https://informatics.bmj.com/content/30/1/e100622.full kostenfrei https://doaj.org/toc/2632-1009 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_21 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 30 2023 1
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Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Computer applications to medicine. 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topic_title	R858-859.7 Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system
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title	Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system
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title_sort	improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system
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title_auth	Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system
abstract	Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.
abstractGer	Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.
abstract_unstemmed	Objectives Computerised provider order entry (CPOE) systems have been implemented around the world as a solution to reduce ordering and transcription errors. However, previous literature documented many challenges to attain this goal, especially in paediatric settings. The objectives of this study were to (1) analyse the impact of a paediatric CPOE system on medication safety and (2) suggest potential error prevention strategies.Methods A pre-post observational study was conducted at the pilot ward (n=60 beds) of a paediatric academic health centre through mixed methods. The implementation project and medication management workflows were described through active participation to the project management team, observation, discussions and analysis of related documents. Furthermore, using incident reports, the nature of each error and error rate was compared between the preperiod and postperiod.Results The global error rate was lower, but non-statistically significant, in the post implementation phase, which was mostly driven by a significant reduction in errors during order acknowledgement, transmission and transcription. Few errors occurred at the prescription step, and most errors occurred during medication administration. Furthermore, some errors could have been prevented using a CPOE in the pre-implementation period, and the CPOE led to few technology-related errors.Discussion and conclusion This study identified both intended and unintended effects of CPOE adoption through the entire medication management workflow. This study revealed the importance of simplifying the acknowledgement, transmission and transcribing steps through the implementation of a CPOE to reduce medication errors. Improving the usability of the electronic medication administration record could help further improve medication safety.
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title_short	Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system
url	https://doi.org/10.1136/bmjhci-2022-100622 https://doaj.org/article/7e5d1fa8e43f4666a3a1b7f08269a4f3 https://informatics.bmj.com/content/30/1/e100622.full https://doaj.org/toc/2632-1009
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Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system

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