Alarm Fatigue In Health Care System

During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left

Equally impressive is the implementation of Computerized Physician/provider Order Entry or CPOE. CPOE is known as one of three key patient safety initiatives by Leapfrog Group, a conglomeration of non-health care Fortune 500 company leaders committed to modernizing the current healthcare system (Huston, 2014; The Leapfrog Group, 2013). CPOE is a type of software designed to reduce errors in transcription due to illegible physician handwritings or wrongly placed decimals in dosage and strengths of medications. CPOE also gives the clinician access to Clinical Decision Support, or CDS, which is a database to assist clinicians and providers to health related information for certain patient diagnosis with care planning assistance and direction. (Huston, 2014; The Leapfrog Group, 2013). CPOE and CDS will likely be streamlined and commonly used in healthcare in the next decade which appears will likely improve patient safety as well as vastly reduce medication and

The identified barriers are financial cost, physician and organizational resistance due to low computer literacy skills and disturbance of workflow caused by CPOE systems. The resistance can be overcomed by strategies such as strong leadership, providing trainings, addressing workflow concerns and advocating related policy changes. (Poon, Blumenthal, & Honour et al. 2004). Currently, Canada Health Infoway ( 2016) has promoted CPOE implementation among health care organizations across Canada. For example, North York General Hospital in Toronto has partnered with Canada Health Infoway to develop CPOE systems and share the order sets freely ( Zeidenberg, 2013). With public awareness of the CPOE gradually increasing, now most physicians recognize the positive impact of using CPOE system to improve patient safety , and they are willing to accept the application (Jung, Hoerbst, & Massari, et al. 2013).

Computerized provider order entry (CPOE) is a significant piece of stage 1 meaningful use. CPOE in Power Chart allows for disease specific order sets decreasing the amount of free texting entries and therefore decreasing the incident of errors. Power Chart also interfaces with the hospital

Clinical alarm systems in acute and critical care health care settings are an assistive way to maintain communication between the client and the nurse. Awareness and comprehension of health devices is crucial to provide nurses with appropriate strategies for critical or non critical interventions that can lead to sentinel events. The ECRI, a nonprofit institute, has identified alarm hazards as the “Top Ten Health Technology Hazards” for 2014. (cite) In 2013 The Joint Commission published a Sentinel Event Alert proposing a National Safety Goal to focus on alarm safety (cite). This topic is pertinent information to be recognized and set as an achievable action in improving patient safety.

Computerize provider order entry has had a tremendous impact on improving patient safety and health care outcomes. As a post-operative unit secretary, I often had the wonderful task of transcribing physician orders. I spent more time trying to contact the physician’s to ensure that I understood their handwriting then actually transcribing the order. There were numerous medication errors made through the assumption of transcribed orders. Consequently, computerized provider order entry helped to significantly reduce those risks. However, I have witness computerized provider order entry errors made by clinicians that the system fails to recognize. For example, a patient reported taking an anxiety medication X 2.5mg PO daily upon admission. Four

The use and advancement of technology has expanded throughout the years. Technology has recently begun to be incorporated into the healthcare setting to enhance patient care, patient safety, and to optimize therapeutic outcomes. This concept is otherwise known as medical informatics, and is composed of six core areas: electronic health records (EHR), computerized provider order entry (CPOE), electronic prescribing, pharmacy automation and dispensing systems, privacy and security of informatics, and telehealth. Computerized provider order entry specifically refers to a licensed healthcare professional inputting medication orders and other medical information into an electronic pharmaceutical program.1 However, implementing CPOE has revealed

Medication errors are among the most common medical errors, harming and costing millions of patients in the world very year. Prevention of medication errors is, therefore, a high priority worldwide. Nowadays, various information technology (IT) systems are widely used to prevent and reduce medication errors. Computerized physician order entry (CPOE) with patient-specific decision support is one of the most powerful IT systems used by physicians to improve patient safety in various healthcare settings. As an example, application of CPOE systems has significantly reduced errors related to dosing of psychoactive medications. Pharmacy dispensing systems, including drug-dispensing

One of the most complex challenges that healthcare facilities face, are the high occurrences of medication errors. Due to increased incidences of medication errors, it has become a major priority for healthcare systems to find preventions that could simply decrease medical errors. With evidence provided from different research healthcare systems are moving more towards using computerized information technology for simple automated notes, too bed-side bar code medication administration, electronic medication reconciliation and physician order entry’s as strategies to decrease medication errors (Agrawal, A. 2009).

According to the Joint Commission 2014, clinical alarm systems are designed to alert staff for any potential patient problems, but they can jeopardize the patient safety, if they are not managed and responded properly. Nurses are known for their ability of multitasking, but everything has a limit. Due to multiple interruptions and distractions, including alarms systems, nurses develop alarm fatigue and try to tune them out and ignore them. "Alarm fatigue occurs when clinicians become desensitized and nonreactive to the sensory overload created by an overwhelming number of alarms, many of which are nuisance or non-actionable alarms” (NACNS 2013-2014).

CPOE stand for Computerized Provider Order Entry “it is a computerized application designed to assist clinical practitioners in creating and managing medical orders for patients and medication. “(HIMSS Dictionary, 2010. P. 28) CPOE has been in place of written or verbal orders by the providers. CPOE allows provider’s to order diagnostic test, administer medication, draw blood, and do imaging studies from a computer or mobile device. The advantage of CPOE is to help manage patient care more effectively and efficiently. To prevent reduce or eliminate medical records and adverse drug events. As well as improve patient safety, reduce unnecessary variation in health care and improve efficiency of health care delivery. Using CPOE can help prevent

Medicine is an always evolving field, and continues to grow in the pursuit of people health benefit. As time has passed better research studies, discoveries, treatments and improvement of patient outcomes has been the pride of the medical field. However; despite all the improvements in medical advancement, preventable medical errors have become a major problem in the field. About a decade ago, the Institute of Medicine (IOM) investigated and created the report To Err Is Human: Building a Safer Health System, in that report the IOM came to the conclusion that approximately 98,000 people has died yearly in the United States as a consequence of an preventable medical error (RWJF, 2011). Some of these errors are caused

Improving patient safety and providing quality care is a top priority in today’s health care forum. Medication errors (MEs) affect many seeking treatment in medical care settings. Computerized provider order entry (CPOE) systems are identified as potential sources for decreasing the occurrence of MEs and adverse drug events (ADEs). Notable health care organizations, including the World Health Organization (WHO), Institute of Medicine (IOM), and the Centers for Medicare and Medicaid Services (CMS), champion CPOE as a solution for improving patient safety and quality of care (Appari, Carian, Johnson, & Anthony, 2012; Cooley, May, Alwan, & Sue 2012; Devine et al., 2010; Khanna & Yen, 2014; Radley et al., 2013; Stone, Smith, Shaft, Nelson, & Money, 2009). Recommendations of CPOE implementation are becoming a motivation for its adoption within the United States (U.S.). While the application of CPOE is growing nationally, there still remains limited utilization. The purpose of this paper is to review the current trends in CPOE adoption, benefits and negative consequences of use, and solutions for CPOE system complications.

While CPOE is built to reduce the medication errors, it has developed errors causing wrong timing errors on medications. An article called Implementation of a custom alert to prevent medication-timing errors associated with computerized prescriber order entry focused on how to implement custom alert that would reduce the timing conflict for medications (Idemoto et al., 2015). The Arthurs Idemoto et al. explained how Virginia Mason Medical Center worked on how to change their current CPOE to prevent medication timing errors from happening (Idemoto et al., 2015). The Arthurs gave an example of administering an antihypertensive medication. They explained that a doctor orders a medicine to start at 7 a.m. and there was another medication that would

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when