Nursing Medication Administration and Workflow Using Computerized Physician Order Entry (CPOE)

2.50
Hdl Handle:
http://hdl.handle.net/10755/158922
Type:
Presentation
Title:
Nursing Medication Administration and Workflow Using Computerized Physician Order Entry (CPOE)
Abstract:
Nursing Medication Administration and Workflow Using Computerized Physician Order Entry (CPOE)
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Tschannen, Dana, PhD, RN
P.I. Institution Name:University of Michigan
Title:School of Nursing
Contact Address:400 N. Ingalls, Rm 4152, Ann Arbor, MI, 48109, USA
Contact Telephone:734 764 0201
Purpose: The benefits of Computerized Physician Order Entry (CPOE) systems have been described widely, however, the impact of CPOE on nursing workflow and its potential for error is unclear. Nurses spend approximately 27% of their time administering medications (Keohane, 2008). The purpose of this study was to determine the impact of a CPOE system on nursing workflow. Methods: An exploratory design using mixed methodology (observations and semi-structured interviews) to capture and time the medication delivery process steps. Nurses employed on an adult intensive care unit (ICU) (n=36 observations) and a general pediatric unit (n=50 observations) involved in CPOE based medication delivery. Results: The total time required for administering medications averaged 507.2 seconds (8.45 min.) in the ICU and 595.67 seconds (9.93 min.) in the pediatric unit. Frequent barriers to workflow were consistent across settings and include systems issues, such as: unable to reconcile medications efficiently, long order sets requiring more time to determine appropriate medication dosage, failure to complete the 5 rights of medication administration, and less frequent interaction and informal modes of communication. Conclusions: Several more steps were required in the process for pediatric patients, including preparing the medications (i.e. crush, dilute, and label meds) and patients (i.e. comforting), which resulted in greater time associated with the delivery of medications. Areas for nursing workflow improvement include: address medication reconciliation and order duplication issues, identify strategies to improve communication processes among the healthcare team, and evaluate the impact of CPOE on standards of practice. Implications: Although variations occur based on patient population, barriers in workflow are consistent across settings, including system issues with technology failures and redundant orders.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleNursing Medication Administration and Workflow Using Computerized Physician Order Entry (CPOE)en_GB
dc.identifier.urihttp://hdl.handle.net/10755/158922-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nursing Medication Administration and Workflow Using Computerized Physician Order Entry (CPOE)</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Tschannen, Dana, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Michigan</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">School of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 N. Ingalls, Rm 4152, Ann Arbor, MI, 48109, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734 764 0201</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">djvs@umich.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The benefits of Computerized Physician Order Entry (CPOE) systems have been described widely, however, the impact of CPOE on nursing workflow and its potential for error is unclear. Nurses spend approximately 27% of their time administering medications (Keohane, 2008). The purpose of this study was to determine the impact of a CPOE system on nursing workflow. Methods: An exploratory design using mixed methodology (observations and semi-structured interviews) to capture and time the medication delivery process steps. Nurses employed on an adult intensive care unit (ICU) (n=36 observations) and a general pediatric unit (n=50 observations) involved in CPOE based medication delivery. Results: The total time required for administering medications averaged 507.2 seconds (8.45 min.) in the ICU and 595.67 seconds (9.93 min.) in the pediatric unit. Frequent barriers to workflow were consistent across settings and include systems issues, such as: unable to reconcile medications efficiently, long order sets requiring more time to determine appropriate medication dosage, failure to complete the 5 rights of medication administration, and less frequent interaction and informal modes of communication. Conclusions: Several more steps were required in the process for pediatric patients, including preparing the medications (i.e. crush, dilute, and label meds) and patients (i.e. comforting), which resulted in greater time associated with the delivery of medications. Areas for nursing workflow improvement include: address medication reconciliation and order duplication issues, identify strategies to improve communication processes among the healthcare team, and evaluate the impact of CPOE on standards of practice. Implications: Although variations occur based on patient population, barriers in workflow are consistent across settings, including system issues with technology failures and redundant orders.</td></tr></table>en_GB
dc.date.available2011-10-26T21:31:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:31:42Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.