Computerized provider order entry systems, or CPOE, was designed as a computer application that would allow physicians to input their medical orders over a secured network and transmit the data to other healthcare professionals to carry out the orders. This system has the capabilities to include standard physician orders, clinical decision support for patient specific conditions, safety alerts, point of care utilization, and a method to securely keep permanent records (Moniz, 2009). With the safety guards provided by CPOE it has the potential to reduce the number of medical errors thus increasing the medical field’s efficiency in patient care. CPOE’s main focus surrounds the nursing utilization of electronic medical administration records, …show more content…
One of the biggest benefits is that the nurse no longer has to decipher the illegible handwriting of the physicians and make guesses that could harm the patient if they are incorrect. This system also includes alerts that notify the medical staff of potential safety issues, as well as provides an easy way to track orders, and the time they were ordered (Moniz, 2009). Another benefit of CPOE is that it promotes use of the five rights of drug administration: the right patient, the right drug, the right dose, the right route, and the right time which allows the nurse to focus on the patient’s assessment before and after drug administration to prevent adverse reactions.
However, there are also many unexpected errors and challenges that have occurred from computerized provider order entry systems. When CPOE first began to come into play in the medical field, it created the challenge for the medical staff of letting go of the paper world, and trusting in the computer systems reliability. There was also worry that the information could be lost in the computer, or cause a delay in the orders (Moniz, 2009). Now that this application has been in play for a few years, it has reversed itself because if the computer system was to crash, the medical staff has to revert back
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The first way nurses can play a role is to trust in the system, and have faith that the systems are credible. Nurses need to believe that CPOE will work better then the traditional paper system. This has been put into play with the parallel system in which nurses dual document in the CPOE, and on the paper chart (Moniz, 2009). Another way nurses can prevent some of these errors is to report the challenges and not avoid them. If the challenges are avoided, and the nurse chooses to by pass the system, or override different alerts, this could potentially lead to a fatality especially during medication administration. If the challenges were viewed as a potential place for improvement instead of a place for avoidance, it could promote a successful intervention of technology in the work place that will save time, and the jobs of many nurses, and physicians. CPOE is also a way for nurses to ensure the care they are providing is well documented, in case of an adverse event, that they did everything such as the five rights of medication administration before the adverse event happened. Nurses can also give feedback regarding the challenges that they face in regards to their workflow, so that when CPOE is evaluated frequently changes can be made to help improve it. Nurses, physicians, and other medical staff are vital players in ensuring patient safety, and CPOE is the key in doing
The users that are already competent with the CPOE system (nurses, pharmacists, doctors) should be more vocal about the benefits of the system, and how because of it they now having more time to manage their patients well being. They must also speak up about what is not working in the system as so improvements can continue to be made.
Springfield General Hospital (SGH) is committed to high quality healthcare for patients, and providing tools to support physicians, nurses and pharmacists. SGH leadership approved the computerized physician order entry (CPOE) system as a solution to reduce prescription errors, and the results of the CPOE project are disappointing. The data show increased prescribing errors after implementing the CPOE; resulting in increased costs for adverse drug events, rather than the planned cost reduction (Spector, 2013). This change management plan provides the SGH board of directors and executive management team pragmatic steps to increase quality for patients by assessing the root issue of hospital
As the evolution of healthcare from paper documentation to electronic documentation and ordering, the security of patient information is becoming more difficult to maintain. Electronic healthcare records (EHR), telenursing, Computer Physician Order Entry (CPOE) are a major part of the future of medicine. Social media also plays a role in the security of patient formation. Compromising data in the information age is as easy as pressing a send button. New technology presents new challenges to maintaining patient privacy. The topic for this annotated bibliography is the Health Insurance Portability and Accountability Act (HIPAA). Nursing informatics role is imperative to assist in the creation and maintenance of the ease of the programs and maintain regulations compliant to HIPAA. As a nurse, most documentation and order entry is done electronically and is important to understand the core concepts of HIPAA regarding electronic healthcare records. Using keywords HIPAA and informatics, the author chose these resources from scholarly journals, peer reviewed articles, and print based articles and text books. These sources provide how and when to share patient information, guidelines and regulation d of HIPAA, and the implementation in relation to electronic future of nursing.
They must be able to appreciate the value of standardization in nursing practice as well as the limitations of the human mind in memorizing and coming up with effective solutions all the time. The practitioner must also play their role in the prevention of errors within the facility while valuing the role of the patient, families and colleagues in as far as monitoring and cross checking is concerned. In addition, they must be able to appreciate the significance of the national safety campaigns and their positive impacts upon implementation in practice.
This technology assist the nurse in confirming patients identify by confirming the patients’ dose, time and form of medication (Helmons, Wargel, & Daniels, 2009). Having an EHR also comes with a program that allows the medical staff to scan medications so medication errors can be prevented. According to Helmons, Wargel, and Daniels (2009) they conducted an observational study in two medical –surgical units one in the medical intensive care (ICU) and one in the surgical ICU. The researchers watched 386 nurses within the two hospitals use bar code scanning before they administrated patients’ medications. The results of the research found a 58 % decrease in medication errors between the two hospitals because of the EHR containing a bar code assisted medication administration
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
Electronic prescribing or known as e-prescribing is the transmission, using electronic media, of prescriptions or prescription-related information from a prescriber (physician, nurse practitioner, etc.) to a pharmacy (Fincham, 2009). The information may flow to a number of parties in addition to the pharmacy, such as a pharmacy benefit manager, health plan, or an intermediary, such as an e-prescribing network (a large centralized system to process electronic prescriptions)(Bloche, 2011). In its simplest form, e-prescribing involves two-way transmissions between the point of care and the pharmacy. E-prescribing is intended to replace writing out, faxing, or calling in prescriptions, and its many proposed benefits include safer, more efficient, and more cost-effective care (Fincham,2009). Because of potential benefits, the federal government has put in place major incentives for providers to adopt e-prescribing and to adopt electronic health records through the meaningful use incentives (Sanders & Buchanan, 2012). But in today’s world where technology is growing rapidly in the healthcare, medication errors through e-prescribing is not getting any better. Medication errors are one of the most common types of medical errors and one of the most common and preventable caus...
Healthcare professionals associated with medical billing and coding know the progress the technology has made so far. In the last few decades, medical billing and coding has switched from being a paper-based system to a computerized format. Under HIPAA laws, medical practitioners had to develop new software in order to send out electronic bills. With the advent of electronic medical records (EMR), with one touch of a button, doctors, Nurse Practitioners and PAs can gain access to all the care a patient has ever received from every healthcare facility the patients visited previously and can figure out possible illnesses. This enables statistical documentation of the population as a whole as well. EMR can also make the healthcare system more transparent and allow integration with reimbursement data. As the healthcare system changes, this will prevent unnecessary costs and make it easier to get the reimbursements needed to treat a patient.
The main quality initiative affected by this workaround is patient safety. The hospital switched to computer medication administration as opposed to paper medication administration documentation because it is supposed to be safer. So, when the nurse gets the “wrong medication” message the computer thinks something is wrong, this is a safety net that is built into the computer system. If the nurse were just to administer the medication without any further checks, he or she would be putting patient safety on the line. The policy involved that pertains to this workaround is the “8 rights of medication administration”, which are: right patient, right medication, right dose, right route, right time, right documentation, right reason, and right response (LippincottNursingCenter®, 2011). Each nurse it taught these eight rights of medication administration in nursing school, therefore it is a nursing policy. When this workaround occurs the nurse should use his/her judgment before “scan overriding” and ensure these eight checks before administering the
Boaden, R., & Joyce, P. (2006). Developing the electronic health record: What about patient safety? Health Services Management Research, 19 (2), 94-104. Retrieved from http://search.proquest.com/docview/236465771?accountid=32521
Computerized Physician Order Entry (CPOE), is also known as Computerized Provider Order Management (CPOM). CPOE is a process of automated or electronic entry record of health care physician on different types of instructions on how to treat patients, especially patients that are hospitalized under a physician’s care. CPOE is one of the most remarkable system that is being used in the healthcare system to effectively reduce the amount of medication errors. The University of Health Care System might be in the process of rolling out the CPOE portion out of the EMR project, however, they did not do a thorough investigation on what CPOE is and whether or not it would have a positive impact on the EMR project. They should have not taken the step to start the project without already knowing the basics of CPOE. They might have had thought that since it is a computerized system everything would turn out okay and there would not be any problems. However, they fall short to recognize that the user’s knowledge and experience with using the CPOE system would have a significant influence on the effectiveness and productivity of the actual system.
Our clinical knowledge is expanding. The researcher has first proposed the concept of electronic health record (EHR) to gather and analyze every clinical outcome. By late 1990s computer-based patient record (CPR) replaced with the term EHR (Wager et al., 2009). The process of implementing EHR occurs over a number of years. An electronic record of health-related information on individual conforms interoperability standards can create, manage and consult with the authorized health professionals (Wager et al., 2009). This information technology system electronically gather and store patient data, and supply that information as needed to the healthcare professionals, as well as a caregiver can also access, edit or input new information; this system function as a decision support tools to the health professionals. Every healthcare organization is increasingly aware of the importance of adopting EHR to improve the patient satisfaction, safety, and lowering the medical costs.
Over the past decade, technological advances have paved the way for nurses to provide, quality, safe, standardized and individualized patient care (Saba & McCormick, 2015). The use of the Electronic Health Records (EHR) to manage patient data is quickly becoming widespread in the healthcare industry. The emerging use of the Electronic Health Record, is transforming how nurses care for patients. By creating and implementing an electronic, comprehensive, standardized method of recording patient data, nurses can facilitate and coordinate patient care with members of the multidisciplinary healthcare team. The use of the Electronic Health Record will promote positive
Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of the nursing profession, taking up to forty percent of a nurse’s time in providing nursing care (Fowler). Consequently, nurses are commonly held accountable for medication errors. To improve the safety of a vital aspect of nursing care, bar code scanning was introduced to reduce errors in medication administration. Although bar code scanning has its advantageous aspects, there are also disadvantageous qualities.
In my facility, nurses rely on numerous technologies to complete their daily tasks, the main one being a computer based electronic medication administration report (eMAR) system. This computer application assists with efficient administration of medication for client in long-term care. “The eMAR application offer nurses a list of Residents for selection, and after a Resident is chosen, the list of medications to be given appears on...