CPOE Barley Scratching the Surface

[rninformatics, DNP, RN]

Survey: CPOE Barley Scratching Surface

More than nine in 10 hospitals have not implemented computer-based provider order entry (CPOE), according to Washington-based The Leapfrog Group, which recently named 59 hospitals to its first Top Hospital List.

Of 1,263 responding hospitals, only 7 percent have fully implemented CPOE (another 7 percent plan to implement it by 2007), representing little progress since Leapfrog began tracking implementation in 2002, when the figure was 3 percent, the organization stated.

On the positive side, the survey found:

Nine in 10 hospitals have implemented procedures to avoid wrong-site surgeries; and,

Eight in 10 hospitals require a pharmacist to review all medication orders before medication is given to patients.

http://www.leapfroggroup.org/cp

[UR10CMPUSH]

I Found Your Thread Very Interesting. I Was Wondering If You Have Any Other Good Websites To Look At On This Topic. See My Post

[rninformatics, DNP, RN]

Sure.

I Found Your Thread Very Interesting. I Was Wondering If You Have Any Other Good Websites To Look At On This Topic. See My Post

CPOE_Leapfrog-CPO_Guide.pdf

CPOEcost_Leapfrog-AHA_FAH_CPOE_Report.pdf

[rph3664]

My hospital is pushing CPOE, but they used the psych department as the pilot and trust me, the problems this caused FAR outweighed the advantages!

The biggest problem was the doctors not having a clue how to enter drug orders into the computer, and we had to re-enter them anyway. One doctor in particular was by far the biggest culprit.

This might make more sense for things like labs and X-rays, where it's straightforward what the doctor wants (IIRC - please correct me if I'm wrong).

[rninformatics, DNP, RN]

Sounds like the issue was poor training prior to and or poor support to the physicians once the system went Live.

CPOE if implemented correctly can improve the medication order entry process by decreasing the time from prescribing to dispensing, improving legiblity of orders and reducing transcription and other common prescribing and dispensing errors. CPOC combined with alerts, results reporting and drug/food interaction checking can also decrease harmful medication errors

My hospital is pushing CPOE, but they used the psych department as the pilot and trust me, the problems this caused FAR outweighed the advantages!

The biggest problem was the doctors not having a clue how to enter drug orders into the computer, and we had to re-enter them anyway. One doctor in particular was by far the biggest culprit.

This might make more sense for things like labs and X-rays, where it's straightforward what the doctor wants (IIRC - please correct me if I'm wrong).

[UR10CMPUSH]

Thanks for the articles. They will be very helpful.

[blueheaven]

In our CPOE system, it seems that every month a new bunch of docs comes through and we have to teach them how to write orders, meds etc. For the most part though our system is pretty straight forward. Our rule is that the nurses DO NOT WRITE ORDERS the MD has to. This means that if the MD wants it done, he is going to have to learn to put it in the system himself, ask one of us how, or ask one of his peers. I personally like that rule, cause if the MDs can get us to do it...they will.

[UR10CMPUSH]

Thank you for your input. It will help us with our project. :thankya:

[Brownms46]

I agree with Angela, that the providers were either not trained properly or did not receive adequate individual support. Our system does not give ANYONE access to the system until they have completed training, and providers are given one on one training, with at least 3 days of on sight one on one support.

I used to do training for the Peds clinics, ASP, and new system providers, and CPOE does work. The Military and the VA have required their providers to enter their own order for over 10 years!