Verified Document

Patient Outcomes And Physicians Essay

CPOE and CDSS A CDSS (decision support alerts) Embedded in a CPOE (Prescribing Order Entry) for Intravenous HEPARIN

ORDER ENTRY

Weight, last heparin dose, and related laboratory tests displayed on the screenDirect by Test Doctor at 13th September 2016-1512

** Wt 94.0 kg (206 lbs) 25 Aug 2247

**Plt

** INR

**aPTT

**Hgb

**Hct

**Preg **Lact

**Hep IVP

**Med Alrg nkda 25 Aug 2247

HePARIN Drip New Order

Platelet Warning:

Low platelet count warningRECOMMENDATION: STOP HEPARIN AND SEND HEPARIN INDUCED THROMBOTCYTOPENIA ANTIBODIES (PLATELT FACTOR 4). Pt

Platelet count has dropped by more than 50% or is less than 100 10^9/L.

Wt Consideration:

Weight Alertrecommendation: RE-TAKE WT. Wt was taken over 72 hours ago.

Baseline Labs:

Missing baseline laboratory results warningRECOMMENDATION: Obtain baseline aPTT, Platelet Count and INR lab values prior to proceeding with order.

Rx & Lab Trend:

Suggested IV Dose:

Suggested weight-based dose1.395 Units/hr (wt (kg) * 15 Units/kg/hr)

Max Dose Alert:

RECOMMENDATION: MAX DOSE 1.000 UNITS/HR. MAX RATE 10 ML/HR.

The Rationale behind Your Design Development

CPOE- Computer Provider Order Entry, along with Clinical Decision Support can enhance the safety of medicine prescription (Kuperman, et al., 2007). The rationale for the development of the physician order entry with CDSS comprises of process enhancement, support for cost-based decisions, support also for clinical decisions, as well as optimization of physicians' timeframe. Also, CPOE with CDS systems is considered one of the best ways to enhance health care service and improved safety of the patients. When the electronic records of the patients become increasingly accessible, the systems will inevitably become the method that medical care staffs will choose. It is a complex process creating a CPOE/CDS system. Indeed, some of them fail even after consuming a lot of resources and time.

How to Implement the CPOE/CDS System

CPOE presents many advantages and disadvantages. If it is not implemented in stages, one is likely to experience the full extent of its pitfalls. It must start with viewing it in the laboratory. The next steps include addition of dictations, viewing of images, basic chart and eventually graduated to CPOE system on form. Even with such pre-implementation precautions, the system can still confuse physicians...

The work-flow of the physicians may be slowed down in some situations. The system mandates a total of five clicks of the mouse for replacing just one non-formulary drug. This means that for a single average patient that needs up to 4 different substitution medications, the physician will have to click 20 times. This is a common occurrence. CDSS was used in order sets form into CPOE building a number of these specifically for individual service and bearing some guiding principles in mind. Adopting and implementing CPOE can take a long time because of the resistance by nursing staffs and physicians along with technical barriers. There should be training availed for all staffs and physicians in particular. The staffs at health facilities must fully understand the workings of the system. It is also important for the suppliers to provide a 24/7 technical system support after delivery to a health facility. It should be noted that training all employees on the workings and intricacies of the system will help the implementation process. Each department should create order sets which should be validated by the medical personnel that will use the system. The decision support rules fed into the system everyday is critical in its use. There should be enhanced interfacing of new standards in case of systems from different suppliers for purposes of transferring information among pharmacists, providers, pharmacy benefit overseers and payers. Technologies also need to be standardized. Standard technologies should be created to establish procedures for assessment and for shared details of dosages of medication, reactions and allergies. There is need for extended research to establish the implementation cost and the benefits of using the CPOE system. The essence of CPOE and its central role in reducing ADEs and medical errors should also be highlighted. Rural and small hospitals will also need some specialized attention based on research. Variation in the amount of resources may influence the adoption rate of CPOE. Moreover, a systematic review and a Meta analysis should be done to gain a precise measure of…

Sources used in this document:
References

Berner, E. S. (2009). Clinical Decision Support Systems:State of the Art. AHRQ Publication No. 09-0069-EF.

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014). Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital Medical Errors and Adverse Drug Events? Perspect Health Inf Manag, 11.

Kuperman, G. J., Bobb, A., Payne, T. H., Avery, A. J., Gandhi, T. K., Burns, G.,... David W. Bates. (2007). Medication-related Clinical Decision Support in Computerized Provider Order Entry Systems: A Review. J Am Med Inform Assoc, 14(1), 29 -- 40.

Niazkhani, Z., Pirnejad, H., Berg, M., & Aarts, J. (2009). The Impact of Computerized Provider Order Entry Systems on Inpatient Clinical Workflow: A Literature Review. J Am Med Inform Assoc, 16(14), 539 -- 549.
Cite this Document:
Copy Bibliography Citation

Related Documents

Patient Outcomes and Theory
Words: 657 Length: 2 Document Type: Essay

Practicum Objective There is a high degree of interrelation between theory, practice and research. Research is the starting point. It involves the gathering of knowledge, and then this knowledge is used to build theories. The theories are then put to the test, first in the research process and then if that is successful theories are put into practice in the real world. Real world practice then becomes the basis for the

Reducing Patient Waiting Time for Better Patient Outcomes
Words: 1292 Length: 4 Document Type:

Reducing Patient Waiting Time for Better Patient Outcomes Step 1 Most healthcare institutions start their day with the intention of perfectly managing their time schedules. While the expected outcome is excellent patient outcome many practices often end up bringing in more patients into a schedule that is already overloaded hence requiring more time to attend to the scheduled patients (Capko, 2015). The outcome of the busy schedules is inefficiency, bottlenecks, frustration, and

Overcoming Ethical Barriers to Improved EOL Patient Outcomes
Words: 1233 Length: 4 Document Type: Research Paper

Ethics in EOL Decisions Finding Common Ground in EOL Care Decisions Churchill (2014) presents to readers a case study to highlight some of the ethical and moral issues that will occur during end-of-life (EOL) decisions. The case study is not a factual event, but represents the mean severity and complexity of the EOL struggles experienced by the typical stakeholders. In this example, the treating physician has unsuccessfully tried to convince the adult

Patient Handoffs Majority of the Medical Errors
Words: 2315 Length: 6 Document Type: Research Paper

Patient Handoffs Majority of the medical errors take place in the patient's handoffs. A shift among the doctors is a common practice. There are a number of old patients who approach around 16 different doctors in a year, while young patients who are healthy refer to normal physicians and to specialists as well (Philibert, 2008). In a hospital normally, less attention is given to the patient by his primary doctor, while

Patient to Nurse Ratio Nursing
Words: 752 Length: 3 Document Type: Research Proposal

Many advocates of the move feel that lower patient to nurse ratio would lead to additional savings because it would reduce nurse turnover rate, lawsuits, complications and length of stay. Nursing unions in the state of California have asked for a PTN ratio of 3 to 1. The health association however agreed on 5 to 1 which sound more reasonable than the originally proposed 10 to 1. (Rothberg, 2005) Patient

Patient Falls in U.S. Healthcare Institutions Is
Words: 885 Length: 3 Document Type: Essay

patient falls in U.S. healthcare institutions is staggering. They increase insurance costs, staff pressure, and even more accidental injuries other than falls. Research has shown that there are a number of ways patient falls may be mitigated: more nursing rounds, patient exercise, and body awareness conditioning. Tai Chi is a Chinese martial art that is practices for both defense training and health benefits, as well as longevity. The overall

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now