Use of computerized physician order entry with clinical decision support to prevent dose errors in pediatric medication orders: a systematic review.

Henna Ruutiainen; Anna-Riia Holmström; Eva Kunnola; Sini Kuitunen

Review

Use of computerized physician order entry with clinical decision support to prevent dose errors in pediatric medication orders: a systematic review.

March 27, 2024

Ruutiainen H, Holmström A-R, Kunnola E, et al. Pediatr Drugs. 2024;26(2):127-143.

View more articles from the same authors.

Computerized provider order entry (CPOE) and clinical decision support (CDS) are widely used tools to help improve safe prescribing practices. This systematic review of 17 studies examined the impact of CPOE systems with CDS in preventing pediatric medication dosing errors. Included studies evaluated CDS tools providing dose range checks, dose calculators, and dosing frequency checks. The majority of studies reported improvements in dose error prevention with use of CPOE-CDS systems, with eight studies reporting significant reductions in dosing errors.

PubMed citation

Free full text

Related Resources From the Same Author(s)

Systemic defenses to prevent intravenous medication errors in hospitals: a systematic review.

July 1, 2020

Systemic causes of in-hospital intravenous medication errors: a systematic review.

March 4, 2020

Identification and safe storage of look-alike, sound-alike medicines in automated dispensing cabinets.

February 3, 2021

How to make medication error reporting systems work—factors associated with their successful development and implementation.

April 22, 2015

National and local medication error reporting systems—a survey of practices in 16 countries.

December 5, 2012

Use of an electronic decision support tool to reduce polypharmacy in elderly people with chronic diseases: cluster randomised controlled trial.

July 29, 2020

Healthcare workers' experiences of patient safety in the intensive care unit during the COVID-19 pandemic: a multicentre qualitative study.

July 12, 2023

Addressing mistreatment of providers by patients and family members as a patient safety event.

February 16, 2022

Communication matters when it comes to adverse events: associations of adverse events during implant treatment with patients' communication quality and trust assessments.

March 15, 2023

Intervention study for the reduction of medication errors in elderly trauma patients.

September 2, 2020

When bad things happen: training medical students to anticipate the aftermath of medical errors.

September 2, 2020

Enhancing patient safety by integrating ethical dimensions to critical incident reporting systems.

April 28, 2021

Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study.

January 27, 2021

Facilitators and barriers of care transitions - comparing the perspectives of hospital and community healthcare staff.

June 16, 2021

May 26, 2021

Perceptions of providing safe care for frail older people at home: a qualitative study based on focus group interviews with home care staff.

November 10, 2021

Learning from incident reporting? Analysis of incidents resulting in patient injuries in a web-based system in Swedish health care.

December 9, 2020

Nurses' perceptions and demands regarding COVID-19 care delivery in critical care units and hospital emergency services.

December 2, 2020

Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.

April 13, 2022

Psychological safety during the test of new work processes in an emergency department.

April 6, 2022

Association of polypharmacy and potential drug-drug interactions with adverse treatment outcomes in older adults with advanced cancer.

July 19, 2023

Fostering a just culture in healthcare organizations: experiences in practice.

August 31, 2022

Role of the regulator in enabling a just culture: a qualitative study in mental health and hospital care.

August 10, 2022

Employee silence in health care: charting new avenues for leadership and management.

August 3, 2022

How different countries respond to adverse events whilst patients' rights are protected.

September 27, 2023

Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study.

September 13, 2023

Family conferences to facilitate deprescribing in older outpatients with frailty and with polypharmacy: the COFRAIL cluster randomized trial.

May 10, 2023

Identifying adverse events in patients hospitalized in isolation or quarantine due to COVID-19.

May 10, 2023

Comfort with uncertainty: reframing our conceptions of how clinicians navigate complex clinical situations.

February 13, 2019

What about doctors? The impact of medical errors.

January 14, 2015

Use of quality indicators to compare point-of-care testing errors in a neonatal unit and errors in a STAT central laboratory.

February 25, 2015

Identifying risk in the use of tumor markers to improve patient safety.

May 4, 2016

The safe day call: reducing silos in health care through frontline risk assessment.

September 24, 2014

What about doctors? The impact of medical errors.

August 20, 2014

Identifying high-risk medication: a systematic literature review.

August 13, 2014

Noise in the operating room—what do we know? A review of the literature.

December 22, 2010

Diagnostic error and clinical reasoning.

January 13, 2010

The $17.1 billion problem: the annual cost of measurable medical errors.

April 20, 2011

Swapping horses midstream: factors related to physicians' changing their minds about a diagnosis.

July 28, 2010

Increased risk of burnout for physicians and nurses involved in a patient safety incident.

June 15, 2016

Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011.

May 25, 2016

Improving disclosure and management of medical error—an opportunity to transform the surgeons of tomorrow.

October 2, 2013

Assessing diagnostic reasoning: a consensus statement summarizing theory, practice, and future needs.

February 6, 2013

Supporting involved health care professionals (second victims) following an adverse health event: a literature review.

August 15, 2012

Information technology interventions to improve medication safety in primary care: a systematic review.

July 10, 2013

The effect of medication reconciliation in elderly patients at hospital discharge.

January 30, 2005

Health care professionals as second victims after adverse events: a systematic review.

October 24, 2012

Using Healthcare Failure Mode and Effect Analysis to reduce medication errors in the process of drug prescription, validation and dispensing in hospitalised patients.

October 3, 2012

Implementing a nurse-shadowing program for first-year medical students to improve interprofessional collaborations on health care teams.

August 22, 2012

Variation in 17 obstetric care pathways: potential danger for health professionals and patient safety?

April 25, 2012

Effect of medication reconciliation at hospital admission on medication discrepancies during hospitalization and at discharge for geriatric patients.

April 11, 2012

Clinical diagnoses and autopsy findings: discrepancies in critically ill patients.

April 11, 2012

Managing alarm systems for quality and safety in the hospital setting.

November 14, 2018

Psychological impact and recovery after involvement in a patient safety incident: a repeated measures analysis.

September 21, 2016

Development of a trigger tool to identify adverse drug events in elderly patients with multimorbidity.

August 30, 2017

Technology-induced errors associated with computerized provider order entry software for older patients.

August 23, 2017

Incidence and severity of prescribing errors in parenteral nutrition for pediatric inpatients at a neonatal and pediatric intensive care unit.

October 4, 2017

Root cause analysis of adverse events in an outpatient anticoagulation management consortium.

May 31, 2017

Electronic medication reconciliation tools aimed at healthcare professionals to support medication reconciliation: a systematic review.

February 28, 2024

Preventing critical failure. Can routinely collected data be repurposed to predict avoidable patient harm? A quantitative descriptive study.

January 29, 2020

Patterns in medication incidents: a 10-yr experience of a cross-national anaesthesia incident reporting system.

December 18, 2019

Risks and medication errors analysis to evaluate the impact of a chemotherapy compounding workflow management system on cancer patients' safety.

February 26, 2020

Clinical outcomes from the use of Medication Report when elderly patients are discharged from hospital.

February 4, 2009

Impact of duty hours restrictions on quality of care and clinical outcomes.

November 21, 2007

Identification of root causes for emergency diagnostic imaging delays at three Canadian hospitals.

August 9, 2006

Potentially inappropriate medication use among elderly home care patients in Europe.

April 15, 2005

How to scale up quality and safety program with the home care accreditation.

April 13, 2022

Exploring the intersection of structural racism and ageism in healthcare.

December 7, 2022

Which adverse events and which drugs are implicated in drug-related hospital admissions? A systematic review and meta-analysis.

March 22, 2023

Using Failure Mode, Effect and Criticality Analysis to improve safety in the cancer treatment prescription and administration process.

March 8, 2023

Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety.

February 22, 2023

Declaring uncertainty: using quality improvement methods to change the conversation of diagnosis.

March 17, 2021

Preventable adverse drug events causing hospitalisation: identifying root causes and developing a surveillance and learning system at an urban community hospital, a cross-sectional observational study.

February 24, 2021

Increasing physician reporting of diagnostic learning opportunities.

December 23, 2020

Improving safety recommendations before implementation: a simulation-based event analysis to optimize interventions designed to prevent recurrence of adverse events.

July 7, 2021

Registered nurses' and medical doctors' experiences of patient safety in health information exchange during interorganizational care transitions: a qualitative review.

November 10, 2021

Pediatric transport safety collaborative: adverse events with parental presence during pediatric critical care transport.

November 10, 2021

The postpartum hemorrhage patient safety bundle implementation at a single institution: successes, failures, and lessons learned,

October 27, 2021

Reporting of unsafe conditions at an academic women and children's hospital.

September 29, 2021

Automation failures and patient safety.

December 2, 2020

Use of an audit with feedback implementation strategy to promote medication error reporting by nurses.

November 25, 2020

Impact of teamwork and communication training interventions on safety culture and patient safety in emergency departments: a systematic review.

January 26, 2022

The benefits and harms of open notes in mental health: a Delphi survey of international experts.

December 8, 2021

Breast cancer screening and overdiagnosis.

August 11, 2021

Patient safety and quality improvement: ethical principles for a regulatory approach to bias in healthcare machine learning.

July 22, 2020

Protecting children from iatrogenic harm during COVID19 pandemic.

July 15, 2020

Conversations on diagnostic uncertainty and its management among pediatric acute care physicians.

April 27, 2022

Evaluation of communication and safety behaviors during hospital-wide code response simulation.

March 2, 2022

Taking up the challenge to improve name and role recognition in the operating room.

February 7, 2024

Uncovering the risks of anticancer therapy through incident report analysis using a newly developed medical oncology incident taxonomy.

December 13, 2023

The racial disparities in maternal mortality and impact of structural racism and implicit racial bias on pregnant Black women: a review of the literature.

December 6, 2023

Investigation of mental and physical health of nurses associated with errors in clinical practice.

October 26, 2022

Effect of lawsuits on professional well-being and medical error rates among orthopaedic surgeons.

August 30, 2023

The state of health, burnout, healthy behaviors, workplace wellness support, and concerns of medication errors in pharmacists during the COVID-19 pandemic.

August 23, 2023

Value assessment of deprescribing interventions: suggestions for improvement.

August 16, 2023

The things we carry: the scope and impact of second victim syndrome.

August 2, 2023

Student mistakes and teacher reactions in bedside teaching.

July 19, 2023

Opportunities for diagnostic improvement among pediatric hospital readmissions.

June 28, 2023

Can the standard configuration of a cardiac monitor lead to medical errors under a stress induction?

July 27, 2022

From COVID-19 pandemic to patient safety: a new "spring" for telemedicine or a boomerang effect?

July 27, 2022

Related Resources

How safe are outpatient electronic health records? An evaluation of medication-related decision support using the Ambulatory Electronic Health Record Evaluation Tool.

January 17, 2024

Do junior doctors make more prescribing errors than experienced doctors when prescribing electronically using a computerised physician order entry system combined with a clinical decision support system? A cross-sectional study.

October 18, 2023

Exploring the impact of safety culture on incident reporting: lessons learned from machine learning analysis of NHS England staff survey and incident data.

August 30, 2023

The impact of transition to a digital hospital on medication errors (TIME study).

August 16, 2023

Impact of a computerized physician order entry system on medication safety in pediatrics-The AVOID study.

June 7, 2023

Human factors and safety analysis methods used in the design and redesign of electronic medication management systems: a systematic review.

May 17, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

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

April 12, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

WebM&M Cases

Overdose of Gabapentin and Oxycodone in a Patient with End-Stage Renal Disease: A Case for Appropriate Interruptive Drug-Disease Alerts.

February 1, 2023

Short- and long-term effects of an electronic medication management system on paediatric prescribing errors.

January 18, 2023

Electronic prescribing systems in hospitals to improve medication safety: a multi-methods research programme.

December 21, 2022

Overriding drug-drug interaction alerts in clinical decision support systems: a scoping review.

September 7, 2022

The electronic prescribing of subcutaneous infusions: a before-and-after study assessing the impact upon patient safety and service efficiency.

June 15, 2022

Interventions to reduce pediatric prescribing errors in professional healthcare settings: a systematic review of the last decade.

June 23, 2021

Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems.

January 13, 2021

ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing-2019.

September 30, 2020

Systemic defenses to prevent intravenous medication errors in hospitals: a systematic review.

July 1, 2020

The impact of technology on prescribing errors in pediatric intensive care: a before and after study.

June 3, 2020

Interventions designed to improve the safety and quality of therapeutic anticoagulation in an inpatient electronic medical record.

April 22, 2020

Evaluation of an electronic dosing calculator to reduce pediatric medication errors.

February 20, 2019

Systematic review of computerized prescriber order entry and clinical decision support.

February 6, 2019

The prevalence of dose errors among paediatric patients in hospital wards with and without health information technology: a systematic review and meta-analysis.

October 24, 2018

Communication failure: analysis of prescribers' use of an internal free-text field on electronic prescriptions.

March 7, 2018

Factors contributing to medication errors made when using computerized order entry in pediatrics: a systematic review.

November 22, 2017

Sustained user engagement in health information technology: the long road from implementation to system optimization of computerized physician order entry and clinical decision support systems for prescribing in hospitals in England.

November 1, 2017

Prescription errors related to the use of computerized provider order-entry system for pediatric patients.

June 14, 2017

Impact of commercial computerized provider order entry (CPOE) and clinical decision support systems (CDSSs) on medication errors, length of stay, and mortality in intensive care units: a systematic review and meta-analysis.

April 26, 2017

Effects of health information technology on patient outcomes: a systematic review.

November 16, 2016

A cross-sectional observational study of high override rates of drug allergy alerts in inpatient and outpatient settings, and opportunities for improvement.

May 25, 2016

See More About The Topic

Hospitals

Ambulatory Care

Pediatrics

Ordering/Prescribing Errors

Computerized Provider Order Entry (CPOE)

Use of computerized physician order entry with clinical decision support to prevent dose errors in pediatric medication orders: a systematic review.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Use of computerized physician order entry with clinical decision support to prevent dose errors in pediatric medication orders: a systematic review.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site