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ㆍ 제목 Transition to a new electronic health record and pediatric medication safety: lessons learned in pediatrics within a large academic health system
ㆍ 조회수 167 ㆍ 등록일시 2018-06-21 07:55:40
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Transition to a new electronic health record and pediatric medication safety: lessons learned in pediatrics within a large academic health system

J Am Med Inform Assoc. 2018 Apr 23. doi: 10.1093/jamia/ocy034. [Epub ahead of print]

 

Abstract

OBJECTIVE: 

While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic.

METHODS: 

Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR. Data was reviewed and compiled by theme.

RESULTS: 

After implementation, there was a 5-fold increase in the overall number of medication safety reports; by the third month the rate of reported medication errors had returned to baseline. The majority of reports were near misses. Three major safety themes arose: (1) enterprise logic in rounding of doses and dosing volumes; (2) ordering clinician seeing a concentration and product when ordering medications; and (3) the need for standardized dosing units through age contexts created issues with continuous infusions and pump library safeguards.

CONCLUSIONS: 

Future research and work need to be focused on standards and guidelines on implementing an EHR that encompasses all age contexts. 

 

https://www.ncbi.nlm.nih.gov/pubmed/29688461

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