|
KMID : 0869620070240030234
|
|
Journal of Korean Society of Hospital Pharmacists
2007 Volume.24 No. 3 p.234 ~ p.242
|
|
|
Effects of the pediatric drug order dosage screening program and the pediatric clinical pharmacists’ activities on drug safety improvement
|
|
Kim Seoung-Lan
Kim Jae-Youn
Kang Min-Kyung
An Sook-Hee
Shin Hye-Young
Ohu Ju-Yeon
Lee Sun-Gyo
Park Sung-Gong
Song Yung-Cheon
|
|
|
Abstract
|
|
|
|
Computerized physician order entry(CPOE) system requires an adequate clinical decision support system(CDSS). Pediatric drug ordering calls for an informational backup at the drug ordering stage for several reasons such as a dosage adjustment due to children’s weight, maximum dose changes due to their growth, and the risk of ten fold dosage mistakes. Noticing the needs of CDSS on maximum dose limits in the pediatric drug ordering system, clinical pediatric pharmacists developed a new screening system and monitored it. In this study, we evaluate the effects on drug safety improvement. The study was conducted in Asan Medical Center. We developed and monitored CDSS after the consultation with the department of pediatrics, drug information center, and Performance Improvement. Using the screening program, the warning massages pops up on the computer screen when high risk orders(overdose, underdose) are given and the program informs clinicians with the drug information. Then, the pediatric clinical pharmacists monitor the ultimate drug adjustment of the high risk orders and give feedbacks to the clinician if necessary. This monitoring was analyzed and evaluated. The inclusion criteria was patients under 16 years old, weighed less than 40kg who were hospitalized or visited the following departments of Asan medical Center.: Pediatrics, Pediatric Surgery, Pediatric thoracic Surgery, and Neonatal (outpatients only). Data were collected from August 1, 2005 to September 15, 2005. Total screened drugs were 181 ingredients, 324 products. 1491 high risk orders with warning signs were collected during 46 days and 352 orders were changed. Improvement of drug safety was achieved through Changed Order and adequately monitored by the clinical pharmacist’s monitoring of ultimate drug dosage adjustment. The feedback of pharmacists’ activities to physicians by the warning message increased the ordering compliance. Changed Order has increased from 6.53(3.33) cases per day during early 15days to 9.47(3.93) later 15 days(p<0.05). Stored Set Orders has decreased from 21.53(11.17) to 9.60(2.44)(p<0.05) per day. In conclusion, the screening program effectively informed the appropriate drug dosage information and the clinical pharmacist activities contributed to increasing the ordering compliances and supporting the drug safety in pediatric drug order.
|
|
|
KEYWORD
|
|
|
pediatric drug order dosage, screening program, pediatric clinical pharmacists, medication error(투약오류), CPOE(computerized physician order entry), CDSS(clinical decision support system), pulse therapy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|