The effect of a computerized prescribing and calculating system on hypo- and hyperglycemias and on prescribing time efficiency in neonatal intensive care patients.
JPEN J Parenter Enteral Nutr
; 37(1): 85-91, 2013 Jan.
Article
em En
| MEDLINE
| ID: mdl-22535919
ABSTRACT
BACKGROUND:
Prescribing glucose requires complex calculations because glucose is present in parenteral and enteral nutrition and drug vehicles, making it error prone and contributing to the burden of prescribing errors.OBJECTIVE:
Evaluation of the impact of a computerized physician order entry (CPOE) system with clinical decision support (CDS) for glucose control in neonatal intensive care patients (NICU) focusing on hypo- and hyperglycemic episodes and prescribing time efficiency.METHODS:
An interrupted time-series design to examine the effect of CPOE on hypo- and hyperglycemias and a crossover simulation study to examine the influence of CPOE on prescribing time efficiency. NICU patients at risk for glucose imbalance hospitalized at the University Medical Center Utrecht during 2001-2007 were selected. The risks of hypo- and hyperglycemias were expressed as incidences per 100 patient days in consecutive 3-month intervals during 3 years before and after CPOE implementation. To assess prescribing time efficiency, time needed to calculate glucose intake with and without CPOE was measured.RESULTS:
No significant difference was found between pre- and post-CPOE mean incidences of hypo- and hyperglycemias per 100 hospital days of neonates at risk in every 3-month period (hypoglycemias, 4.0 [95% confidence interval, 3.2-4.8] pre-CPOE and 3.1 [2.7-3.5] post-CPOE, P = .88; hyperglycemias, 6.0 [4.3-7.7] pre-CPOE and 5.0 [3.7-6.3] post-CPOE, P = .75). CPOE led to a significant time reduction of 16% (1.3 [0.3-2.3] minutes) for simple and 60% (8.6 [5.1-12.1] minutes) for complex calculations.CONCLUSIONS:
CPOE including a special CDS tool preserved accuracy for calculation and control of glucose intake and increased prescribing time efficiency.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terapia Intensiva Neonatal
/
Sistemas de Apoio a Decisões Clínicas
/
Sistemas de Registro de Ordens Médicas
/
Prescrições
/
Glucose
/
Hiperglicemia
/
Hipoglicemia
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
Idioma:
En
Revista:
JPEN J Parenter Enteral Nutr
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Holanda