Prevention of potential errors in resuscitation medications orders by means of a computerised physician order entry in paediatric critical care

Introduction: Computerised physician order entry with clinical decision support system (CPOE + CDSS) is an important tool in attempting to reduce medication errors. The objective of this study was to evaluate the impact of a CPOE + CDSS on (1) the frequency of errors in ordering resuscitation (CPR) medications and (2) the time for printing out the order form, in a paediatric critical care department (PCCD). Methods: Setting: An 18-bed PCCD in a tertiary-care children's hospital. Design: Prospective cohort study. Measures: Compilation and comparison of number of errors and time to fill in forms before and after implementation of CPOE + CDSS. Time to fill in conventional, simulated and CPOE forms was measured and compared. Results: There were three reported incidents of errors among 13,124 CPR medications orders during the year preceding implementation of CPOE + CDSS. These represent errors that escaped the triple check by three independent staff members. There were no errors after CPOE + CDSS was implemented (100% error reduction for 46,970 orders). Time to completion of drug forms dropped from 14 min 42 s to 2 min 14 s (p < 0.001). Conclusions: CPOE + CDSS completely eliminated errors in filling in the forms and significantly reduced time to completing the form.