Background

Evaluations of computerized provider order entry (CPOE) systems have revealed that reductions in certain types of medication errors occur simultaneously with the emergence of system-related errors – errors that are unlikely or not possible to occur with the use of paper-based medication charts. System-related errors appear to persist many years post-implementation of CPOE, although little is known about whether the types and rates of system-related errors that occur immediately following CPOE implementation are similar to those that endure or emerge after years of system use.

Objective

To analyze and synthesize the literature on system-related errors, specifically in relation to the length of time that CPOE systems have been in use, to determine what is currently known about how system-related errors change over time.

Methods

A literature search was undertaken using the PubMed database to identify English language articles published between January 2005 and March 2020 that provided original data on system-related errors resulting from CPOE system use. Studies were included if they provided results on system-related errors and information relating to the length of time that CPOE had been in use.

Results

Thirty-one studies met the inclusion criteria for this narrative review. System-related errors were identified and described during short, medium and long-term use of CPOE systems, but no single study examined how errors changed over time. In comparing findings across studies, results suggest that system-related errors persist with long-term use of CPOE systems, although likely to occur at a reduced rate.

Conclusions

This review has highlighted a significant gap in knowledge on how system-related errors change over time. Determining what and when system-related errors occur and the system factors that contribute to their occurrence at different time points after CPOE implementation is necessary for the future prevention and mitigation of these errors.

中文翻译：

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与医院计算机化供应商订单输入系统相关的药物错误以及它们如何随时间变化：叙述性审查

背景

对计算机化供应商订单输入 (CPOE) 系统的评估表明，某些类型的用药错误的减少与系统相关错误的出现同时发生——这些错误在使用纸质用药图表时不太可能或不可能发生。与系统相关的错误在 CPOE 实施后似乎会持续多年，尽管很少有人知道在 CPOE 实施后立即发生的系统相关错误的类型和比率是否与系统使用多年后仍然存在或出现的错误相似。

客观的

分析和综合有关系统相关错误的文献，特别是与 CPOE 系统使用的时间长度相关的文献，以确定目前已知的系统相关错误如何随时间变化。

方法

使用 PubMed 数据库进行了文献搜索，以确定 2005 年 1 月至 2020 年 3 月期间发表的英文文章，这些文章提供了有关因使用 CPOE 系统而导致的系统相关错误的原始数据。如果研究提供了与系统相关的错误的结果以及与 CPOE 使用时间长度相关的信息，则研究被纳入。

结果

31 项研究符合本叙述性综述的纳入标准。在 CPOE 系统的短期、中期和长期使用过程中识别和描述了与系统相关的错误，但没有一项研究检查错误如何随时间变化。在比较研究结果时，结果表明系统相关错误在长期使用 CPOE 系统的情况下持续存在，尽管发生率可能会降低。

结论

本次审查强调了在系统相关错误如何随时间变化的知识方面存在重大差距。确定什么和何时发生系统相关错误以及在 CPOE 实施后的不同时间点导致其发生的系统因素对于未来预防和减轻这些错误是必要的。