CPOE Themed Annotated Bibliography

Charles, K., Coustasse, A., & Willis, K. (2014). Does CPOE Increase Patient Safety by Reducing Medical Errors? Global Education Journal, 2014(1), 1-14. The purpose of the research project was to determine if adoption of a CPOE system would be an effective elucidation to the problem of medical errors as well as determine what caused the medical errors. The results pointed to reduction in adverse drug events and medical errors significantly using CPOE and demonstrate through review that CPOE provides a higher accuracy through ease of electronic use of data.

Evidence: By using information taken from previous research articles and studies, the authors determined CPOE can minimize medical errors and can be beneficial especially due to the financial incentives brought on by the HITECH Act of 2009. Relation: This source supports other sources and evidence because it shows how beneficial CPOE is to patient care through reduction of medical errors. Currency: This is a recent article published in 2014. Relevance: This article is pertinent to the topic as it addresses quality care and addresses some of the anxieties concerning CPOE implementation.

Accuracy: This is an in-depth qualitative case study with various sources and research methods, making it very accurate. They use interviews as well as documents that they searched for via established search engines. Authority: The authority is Global Education Journal as they are the ones that published the article. Purpose: This source would add greatly to the paper because it shows CPOE can be used to promote quality patient care through reduction of medical errors. Cresswell, K., Bates, D., Williams, R., Morrison, Z., Slee, A., & Coleman, J. et al. (2014).

Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals. Journal of The American Medical Informatics Association, 21(e2), e194-e202. http://dx.doi.org/10.1136/amiajnl-2013-002252 Purpose: The aim of this study was to comprehend what the medium-term consequences are of CPOE implementation as well as clinical decision support systems in hospitals that adopted such things early on.

Content: They examined and performed in an in-depth qualitative case study of two hospitals that either used a CDS or CPOE system for a minimum of two years. While one hospital used CPOE, the other invested more and integrated electronic health records into the CDS system. Evidence: From the eleven documents obtained and 43 interviews conducted, they identified 3 major themes: greater legibility of prescriptions, new safety risks for accessibility and usability, and organizational benefits via secondary uses of data. Relation: This is highly relevant as it discusses the use of CPOE.

Currency: Another recent article, it was published in 2014. Relevance: This article is highly relevant because it assesses the quality of CPOE in patient care. Accuracy: This study is highly accurate as they gained information from both documents and in-depth interviews. Authority: The qualitative study was published under the journal of the American Medical Informatics Association and feature on the oxford journals website.

Purpose: This source provides a way in which CPOE can be used to improve patient care because they identified little difference in terms of negative consequences for using either a CPOE or a CDS system and shows the significance of creating future studies that investigate the consequences of implementation of CPOE and CDS system in hospitals. Dowding, D., Randell, R., Gardner, P., Fitzpatrick, G., Dykes, P., & Favela, J. et al. (2015). Dashboards for improving patient care: Review of the literature. International Journal of Medical Informatics, 84(2), 87-100.

http://dx.doi.org/10.1016/j.ijmedinf.2014.10.001 Purpose: The purpose of this review is to provide a comprehensive overview of currently available evidence for use of quality and clinical dashboard within health care environments. Content: The authors performed a literature search looking for articles from 1996-2012 from several databases, Medline, Embase, Cochrane Library, Science Direct, and the ACM Digital Library. From the 122 full text papers, only 11 made it into the review where the examined the evidence and provided their interpretation.

Evidence: The authors derived from the 11 selected articles there was considerable heterogeneity as it related to implementation setting, indicators used, and dashboard users. Relation: While the source did not provide information exclusively concerning CPOE, it did highlight that ease of access that CPOE brings can indeed improve patient outcomes and thus patient care. Currency: This is a very recent article, published in 2015. Relevance: This is somewhat relevant because the main focus is not CPOE.

Accuracy: This source is a review so information may not be as accurate as it would be with statistical representation of analysis. Authority: The journal in which the review was published is the International Journal of Medical Informatics and is shown on the ScienceDirect website.

Purpose: This source provides supporting evidence that CPOE is a way to improve patient care by showing the evidence points to contests where clinicians had easy access to dashboards like in the way of a screen saver and through the ease of use, was associated with improved patient outcomes and care processes. Leu, M., Morelli, S., Chung, O., & Radford, S. (2013). Systematic Update of Computerized Physician Order Entry Order Sets to Improve Quality of Care: A Case Study. PEDIATRICS, 131(Supplement), S60-S67.

http://dx.doi.org/10.1542/peds.2012-1427g Purpose: The purpose of this case study is to show that it is not enough to just implement CPOE. There needs to be additional steps taken in order to address both clinical correctness and appropriateness.

Content: This is a case study that examined the development process of assigning order set ownership, applying and creating standards for how an order via CPOE should be organized and appear within order sets, support and update multidisciplinary review, and enforce submitting of finished specification prior to the CPOE build. Evidence: From the 98 orders created via standard order formats, and 191 order that were standardized, they identified medication issues in a third of the order sets used in almost half of inpatient admissions.

Relation: This is somewhat relevant because it provides an update to the topic. Currency: A slightly older source than the rest, this article was published in 2013. Relevance: This source is relevant because it shows how CPOE can be beneficial to patient care through adding additional levels of correctness that would increase accuracy and reduce order set errors. Accuracy: Since is an updated version of an already reviewed and evaluated article, it is accurate. Authority: The authority is AAP Gateway.

Purpose: This source gives updated information that supports CPOE implementation promotes quality patient care through increasing accuracy via more legible prescriptions and ease of access. McCrory, M., Strouse, J., Takemoto, C., & Easley, R. (2014). Computerized Physician Order Entry Improves Compliance with a Manual Exchange Transfusion Protocol in the Pediatric Intensive Care Unit. Journal of Pediatric Hematology/Oncology, 36(2), 143-147.

http://dx.doi.org/10.1097/mph.0b013e31828e55e6 Purpose: The purpose of this source was to use a CPOE protocol on manual RBC (red blood cell) exchange transfusion in patients (critically ill children) that suffer from sickle cell disease. Content: It is a quantitative study examining effects of compliance with manual exchange protocol with the introduction of CPOE. Evidence: By conducting a seven-year retrospective study of affected children, they found outcomes from compliance using CPOE included percentage reduction in sickle hemoglobin, and lower hemoglobin levels post-CPOE.

They used statistics in order to determine the outcomes and percentages. Relation: This source is highly relevant because it addresses what specifically can be improved using CPOE. Currency: As with all periodicals, it will not receive any updates and is two years old. Relevance: This source is very relevant as it directly addresses the topic. Accuracy: This source is fairly accurate as it prevents multiple sources of information. Authority: It was published.