Establishment of clinical decision support system for physician order of total nutrient admixture / 中华临床营养杂志

Objective:To establish a design of a clinical decision support (CDS) system ithin the computerized physician order entry (CPOE) system to ensure the correct prescribing of total nutrient admixture (TNA) orders.Methods:An improved new workflow was designed in consideration of both the TNA and doctor's prescription work flow. An exclusive CPOE interface for TNA physician order was established, within which a CDS mode was also created. When individual components of the TNA physician order are inputted, automatic calculation is performed through CDS to determine whether patient's clinical nutritional needs and pharmaceutical process requirements are both met. The generated feedback is presented directly to the prescribing clinician in the interface. Through rationality assessment of physician orders and real-time alarm feedback for inappropriate orders, the system can achieve pre-review of TNA orders as well as the education for clinicians on parenteral nutrition order prescription.Results:The usable drug catalog is created at the back end of CDS, thus precluding unreasonable medical orders of therapeutic drugs in TNA regimens. The background CPOE auxiliary support system for parenteral nutrition can correctly evaluate the reasonability of the carrier solution and provide real-time feedback in the CPOE interface.Conclusion:The establishment of the CPOE auxiliary support system eliminates the possibility of unreasonable component proportions and admixture with other therapeutic drugs in TNA orders to ensure TNA orders with rationale component proportion and good compatibility and stability, ultimately satisfying patient's daily calory need and guaranteeing medication safety of parenteral nutrition.

The Physician Order for Standardized Concentration of Adult's Electrolyte Replacement Therapy: New Initiative in Saudi Arabia

The electrolyte replacement therapy consternation considered one of the high alert drugs. Most of the medication safety organizations have established preventive guidelines for the prescription of electrolyte therapy. The General Administration of Pharmaceutical Care at the Ministry of Health in the Kingdom of Saudi Arabia also has established guidelines for the preparation and administration of electrolyte replacement for adult patients. This new initiative is regarding the standardized concentration of electrolyte preparation and administration for adult patients. The electrolyte therapy may be prescribed via a physician order form, which may be easily converted as computerized physician order entry. This from is designed to prevent all electrolyte-related errors and improve patient outcomes. This project is a new tool implemented for electrolyte safety at the Ministry of Health hospitals in the Kingdom of Saudi Arabia.

Evidence-Based Cancer Imaging

With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.

The Implementation and Generalization of Matching between Computerized Physician Order Entry and Charging Items / 中国卫生经济

Objective: To investigate effective matching between computerized physician order entry and charging items in the hospital. Methods: Standard data of computerized physician order has been established, in which physician order items and charging items have been matched. It has effectively solved the problems in the process of computerized physician order entry. Results and Conclusion: The implementation of matching computerized physician and costs has effectively controlled the errors and missing of costs, which released the complaint of patients and received the good reputation and welcome, the compliance of doctors using computerized physician order entry has been obviously improved, meanwhile, it has provided new application experiences for implementing the following charging of national medical services prices in hospitals.

Evaluation of the Efficiency of a Computerized Physician Order Entry System Serving Pediatric Patients who Visit the Emergency Ddepartment

PURPOSE: The purpose of this article was to evaluate the efficiency of an automated prescription program serving pediatric patients who visited our emergency department. We expected that the program would reduce pediatric patient prescription errors and shorten the length of stay in the emergency department. METHODS: We developed the computerized physician order entry system to serve the pediatric patients visiting the emergency department and recommended that the emergency medicine residents use this program. We compared the rate of error as it affected prescription dosage and length of stay in the emergency department, before and after the program was deployed. We also performed a survey with 20 emergency medicine residents that have used the program. RESULTS: Of the total number of prescriptions filled, the number of prescription dosing errors observed was 40(4.5%) before and 22(2.8%) after the program was deployed. The results of the survey revealed high system usability and satisfaction. However, the length of stay in the emergency department was not affected. CONCLUSION: The computerized physician order entry system for pediatric patients visiting the emergency department was effective in reducing prescription related medical errors.

Monitoring on Irrational Use of Drugs in the Inpatients in Our Hospital by MTP Intervention / 中国药房

OBJECTIVE: To verify the monitoring effects on irrational physicians'orders by MTP intervention in our hospital.METHODS: The irrational physicians' orders in our hospital between 2005 and 2007 were monitored by PASS using MTP(Monitoring-Training-Plan) intervention model.RESULTS: As compared with before intervention,the black-lamp-precaution-medication's revision rate increased significantly after intervention,which greatly reduced the incidence of potential adverse drug events.CONCLUSION: MTP intervention can arouse physicians' attention on the monitoring results with PASS,increase the black-lamp-precaution-medication revision rate and prevent the occurrence of medication errors.