Search results for "Electronic Health Records"

This human factors study examined how electronic health record (EHR) implementation affected medication safety. Researchers encountered improvements in transcription, dispensing, and administration errors after EHR introduction. Several types of medication prescribing errors, including choosing the wrong drug, duplicate orders, or orders with incorrect information, increased with EHR use. This study adds to the evidence suggesting EHR implementation has mixed effects on medication safety.

Despite the demonstrated success of technology in reducing medication errors, preventable adverse drug events remain a significant source of harm to patients. Researchers analyzed data on medication safety events in 2 ICUs at a medical center and found 1622 preventable adverse drug events among 624 patients. About one third of these events were related to electronic health record use, including duplicate orders.

Information provided at bedside rounds is critical for clinical decision-making in inpatient settings. This direct observation study found that laboratory data reported at rounds is prone to error, most often omissions. The authors suggest that inaccurately communicated laboratory data is a prevalent and underrecognized patient safety concern.

The design of electronic medical record (EMR) interfaces according to human factors engineering principles is crucial to ensuring clinicians' ability to access and process data rapidly. This usability study compared a custom-designed interface with a standard off-the-shelf EMR, and found that intensive care unit physicians were able to complete patient care tasks rapidly and with greater accuracy using an interface designed with provider workflow in mind.

This study found that ICU nurses were more accepting of electronic health records (EHR) at 12 months after implementation compared to 3, and this acceptance was predicted by EHR usability and computerized provider order entry usefulness.

This study found that laboratory values designated as "abnormal" or "panic" in the electronic health record, which are considered passive alerts, are very common for patients in the intensive care unit. The authors suggest that these passive alerts contribute to the pervasive problem of alert fatigue in the intensive care unit.

Adherence to quality and safety measures (such as informed consent, presence of urinary catheters, deep venous thrombosis prophylaxis, and medication reconciliation) improved in a pediatric intensive care unit after implementation of an electronic dashboard which displayed real-time data about each of these practices. This study illustrates the importance of providing real-time data to frontline providers as a method to augment adherence to patient safety practices.

In this educational study, medical residents missed patient safety issues in a simulated review of the electronic health record. Repeated simulations resulted in improved but suboptimal performance. These findings support the widespread concern that problems with electronic health record usability lead to patient safety events.

Residents and fellows frequently failed to identify serious clinical abnormalities when asked to review the electronic medical record (EMR) of a simulated intensive care unit patient, indicating that the design of the EMR may affect situational awareness.

One unintended consequence of integrating information technology into health care has been the copy-and-paste phenomenon in clinical documentation—the verbatim copying of information from note to note, which can result in perpetuating incorrect or irrelevant information. This cohort study conducted in an academic medical center ICU found copying and pasting to be near universal among residents and attending physicians, with more than 20% of the note being directly copied from the prior day's note in nearly three-quarters of the notes analyzed. Prior studies have shown that physicians do not feel copying information impairs the quality of care. Although this study did not directly assess if errors occurred due to copying and pasting, an AHRQ WebM&M commentary illustrates how indiscriminate copying of information can lead to preventable harm.

This supplement covers issues related to safety indicators, fatigue, electronic medical records, infection, and disclosure of medical errors in the care of critically ill children.

Failure to enter documentation of a DNR order causes a severely ill elderly man to be resuscitated against his wishes. Shortly thereafter, the patient's wife confirms his wishes, and within minutes, the patient dies.