Computerized Drug-Entry System Essay

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

An error can cost the hospital hundreds of thousands of dollars. Utilizing technology to prevent errors will result in cost savings to the hospital. Implementing CPOE will not only save in prevention of medication errors but also in the decreased time spent in order verification due to illegible handwriting.

Steele, A. M., & DeBrow, M. (2008). Efficiency gains with computerized provider order entry. In: Henriksen K, Battles JB, Keyes MA, Grady ML (eds) Advances in patient safety: new directions and alternative approaches AHRQ publication no 08–0034-4, vol 4. Technology and Medication Safety Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/qual/advances2/

CPOE systems have been proven to decrease medication errors and promote patient safety effectively. A study (Patent Safety Primer, 2014) suggested that 90% of medication errors occurred during the ordering or transcribing stages, and a systematic literature review shows that CPOE was able to reduce those errors by 48% compared to paper-based orders ( Radley, Wasserman & Bradshaw, et al. 2013). CPOE systems are effective in reducing medication errors by eliminating problems related to hand writing,

Improved patient safety is the most essential advantage of the BCMA system. “On average a hospital patient is subjected to at least one medication error per day (IOM, 2006)”(Foote). BCMA significantly reduces medication errors that cause a compromise in patient safety. The BCMA verifies the five rights of medication administration before a patient receives a medication by the software alerting the nurse if there is a contraindication between the medicine scanned and the patient’s orders. A pilot study conducted at a 300-bed community hospital found that the BCMA system reduced medication errors by 80% (Foote). Fowler et al states that “decrease in errors related to the wrong patient was a direct result of the bar code system (Fowler).”

Medication errors are among the most significant cause of patient injury in all types of medical errors (Johnson, Carlson, Tucker, & Willette, n.d). In the nursing profession, medication administration errors occur 34% of the time, second only to physician ordering errors (Gooder, 2011). The introduction of information technology, such as the Bar Code Medication Administration (BCMA), offers new opportunities for reducing medication administration errors. BCMA was developed by the Veteran’s Affairs Medical Center in 1998 to help improve the documentation of medication administration, decrease medication errors and provide

“Handwriting has always been, and will remain, a problem in medicine. A 1979 study showed that it was difficult to interpret about half of all physicians' handwritten orders. Little has changed since then,” (In the long run, penmanship classes for doctors won't do much for patient safety, 2001). This has been an ongoing problem since inception. Therefore, the beginning of the process should be changed in this day and age of technology to have prescriptions entered into computers and handheld devices by the doctor, to ensure accuracy of the medication that is needed to be filled, and electronically sent to the pharmacy. Having a nurse call in prescriptions is a non-value added activity that can be eliminated. This may be expensive at the start to implement, but in the long term, it will save both organizations time, help reduce errors, and add value to the level of service the organization gives. With this change, label errors should also be reduced as well, ensuring the patient receives the correct medicine and dosage.

Please list outcomes of any/all drug screens. Please include the date, type, results, and substance (if applicable)

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when

On the other hand, having a computerized order entry leads to better quality of care as processes and all activities taking place are now automated in the computers. With reduced paperwork, these processes become fast and a lot of time is saved (Wolper, 2011). A doctor is able to examine more patients in an effective manner because he can quickly pull the records and get information of a patient who had previously visited the hospital in a matter of seconds.

The data entry stage has two major problems. The first problem is drug utilization review (DUR). As showed by PSI team for the pharmacy fulfillment process, DURs arise frequently and pharmacists must waste time to intervene. CVS’s central database of customer fails to update and understand customers’ newest condition, so that the issue of DUR triggers customer’s dissatisfaction and wastes a lot of time for pharmacists. The second problem in the data entry stage is no refill allowance. Many customers may lose track of how many refills that were allowed and drop off an ineligible script

If I was a Physician that worked in a doctor’s office, I would have nothing but great things to say about e-Prescribing. If my supervisor asked me to present five positive aspects to my team, I would have no problem at all. E-Prescribing is a great new peak in technology that essentially will make the lives of physicians easier. Doctor’s offices are always packed with many people waiting on appointments and e-Prescribing will allow for appointments to run more smoothly, on time, and with less mistakes. The first positive point that I would make about this new technology is that it makes it easier to verify insurance. The tools presented within this system allow for physicians to see what type of medications the patients insurance will cover.

Not only does the electronic method of prescribing save time, it has also cut down on the number of accidents caused by the misinterpretation of handwriting. Although now almost obsolete, hand-written prescriptions have been the cause of many medical errors because certain sound-alike or look-alike drugs have, in the past, been incorrectly substituted for one another. A report given by the insurance company, Excellus BlueCross BlueShield disclosed that if all physicians were to begin using electronic-prescription systems, “more than two million adverse reactions or events – ranging from inconsequential to severe – could be avoided each year” (wgrz.com). According to pharmacist and associate director for the Food and Drug Administration’s Office of Drug Safety, Jerry Phillips, “Six-hundred sound-alike or look-alike drug pairs have been identified as possible sources of error since 1992” (nytimes.com). For example, Lamictal, a mood-stabilizing anticonvulsant, is quite similar in spelling to Lamisil, an antifungal drug. Because of these strong similarities, it is not difficult to understand how easy it could be for medical personnel to mistake certain medications. But with e-prescribing, because the prescription is sent directly from the prescriber to the pharmacy, the number of accidents caused by misinterpretation of handwriting has already been

In a surface examination of the work of Nathaniel Hawthorne, it is quickly evident that no good things come from the wilderness. Therein, the wilderness is often associated with the savages and the devil. In his work The Scarlet Letter, Hester Prynne finds herself exiled by society for having an adulterous affair with the town reverend which brought forth the child known as Pearl. Pearl is quickly established as the child of the wilderness: wild, capricious, and thought by the town to be a demon-child. She represents several entities in the novel just by her being, but when her morality is delved into, much more of the nature of the story can be revealed. Pearl’s role is often overlooked as a formative force in the novel. Some scholars have gone as far as to denounce her as unnecessary to the story’s makeup. Upon close examination, it can be determined that Pearl is indeed a necessary element. In Nathaniel Hawthorne’s The Scarlet Letter, Pearl presents themes of morality, both personal and cultural, as well as the divide between society and nature, through her interactions with Hester, Reverend Dimmesdale, and the scarlet letter itself.

However, there are issues with this system as well because the computer is only as smart as we allow it to be. If pharmacy puts in the computer the wrong medication or dose, or information is incorrect, the computer will still allow you to administer. It goes back to communication, knowing your patient and how important it is to still ask questions and have conversation with your patient about the medication you are about to give them. Read their history and physical to get a better idea of everything going on with your patient so we can continue to provide safe quality care.