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A systematic review of the types and causes of prescribing errors generated from using computerized provider order entry systems in primary and secondary care.


ABSTRACT: Objective:To understand the different types and causes of prescribing errors associated with computerized provider order entry (CPOE) systems, and recommend improvements in these systems. Materials and Methods:We conducted a systematic review of the literature published between January 2004 and June 2015 using three large databases: the Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline. Studies that reported qualitative data about the types and causes of these errors were included. A narrative synthesis of all eligible studies was undertaken. Results:A total of 1185 publications were identified, of which 34 were included in the review. We identified 8?key themes associated with CPOE-related prescribing errors: computer screen display, drop-down menus and auto-population, wording, default settings, nonintuitive or inflexible ordering, repeat prescriptions and automated processes, users' work processes, and clinical decision support systems. Displaying an incomplete list of a patient's medications on the computer screen often contributed to prescribing errors. Lack of system flexibility resulted in users employing error-prone workarounds, such as the addition of contradictory free-text comments. Users' misinterpretations of how text was presented in CPOE systems were also linked with the occurrence of prescribing errors. Discussion and Conclusions:Human factors design is important to reduce error rates. Drop-down menus should be designed with safeguards to decrease the likelihood of selection errors. Development of more sophisticated clinical decision support, which can perform checks on free-text, may also prevent errors. Further research is needed to ensure that systems minimize error likelihood and meet users' workflow expectations.

SUBMITTER: Brown CL 

PROVIDER: S-EPMC7651904 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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A systematic review of the types and causes of prescribing errors generated from using computerized provider order entry systems in primary and secondary care.

Brown Clare L CL   Mulcaster Helen L HL   Triffitt Katherine L KL   Sittig Dean F DF   Ash Joan S JS   Reygate Katie K   Husband Andrew K AK   Bates David W DW   Slight Sarah P SP  

Journal of the American Medical Informatics Association : JAMIA 20170301 2


<h4>Objective</h4>To understand the different types and causes of prescribing errors associated with computerized provider order entry (CPOE) systems, and recommend improvements in these systems.<h4>Materials and methods</h4>We conducted a systematic review of the literature published between January 2004 and June 2015 using three large databases: the Cumulative Index to Nursing and Allied Health Literature, Embase, and Medline. Studies that reported qualitative data about the types and causes o  ...[more]

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