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Evaluators comment: Front page missing. Partial analysis done for the case.

Suggestions and
adding new portal could have been much more explanatory. Genuine suggestions.
Mars: !" of #"
The Efect of Computerized Physician Order
Entry
and Decision Support System on Medication
Errors
in the Neonatal Ward: Eperiences from an
!ranian
teachin" hospital
!ntroduction:#
This case study is a$out the medication errors in neonatal in !ranian
teachin" hospital% The error rate in medication dosin" error in anti$iotics
and anticon&alscent 'as ()* Which 'as not si"ni+cantly chan"e after
the implementation of CPOE ,computerised physician order entry - 'ithout
decision support system,DSS-% .ut errors 'ere si"ni+cantly reduced to
)/* after the decision support 'as added to CPOE%
ANALYSIS:#
There are medication errors 0 transcription errors in the hospital 'hich
are responsi$le for prolon" hospital stay and increase cost and mortality
rate% Potential ad&erse dru" e&ents occur three times more often in
ne'$orns than in adults%
1fter the CDSS installation2 There are some elimination of the self
reported dose calculation errors of anti$iotics in N!C3 $ut despite of the
$ene+ts implementation of CPOE is challen"in" $ecause of physician
resistance and hi"h cost physicians complaints 'ith the systems
recommendation is lo' and ma4ority of the 'arnin"s are i"nored%
When the CDSS is installed alon" 'ith DSS in hospital 567 calculator is
used for neonates 'hich is $ased on creatinine clearance $ody surface
area2 a"e 0 "estational a"e% .ased on all a$o&e information the clinical
interface unit calculated the patients speci+c appropriate dose and
fre8uency2 and compare the result 'ith the prescri$ed dose and
fre8uency% !f the dose is not 'ithin the normal ran"e the DSS informed the
prescri$er a$out the appropriate dose and fre8uency $y "i&in" a 'arnin"
messa"e that as9ed for correction%


Schematic &ie' of the CDSS architecture2 and is interaction 'ith the
prescription system
RECOMMENDATION & SUGGESTIONS:#


They need to impro&e their decision support system so that
transcription errors can also $e eliminated from hospital%
The :!S should $e such that it can $e easy to use $y health care
people %
Proper trainin" should $e "i&en time to time for nurses and doctors
so that paper 'or9 should $e restricted from the hospital so that
errors are ne"li"i$le%
Their should $e proper chec9 durin" clinical rounds so that potential
ad&erse e&ents
1nd medical faults at the time of prescription is minimised%
NEW PO7T1;S:#

<- !mmunisation portal :# immunisation portal can $e added in
hospital information system for neonatal $a$ies $orn in the
hospital%
=- Child support and care portal:# this portal can $e added to :!S for
the help of poor people>s children and orphana"e children%
)- Child health care life insurance portal:# this portal can $e added
in :!S so that parents of ne'ly $orn child in&est in the policies of
health insurance for their $etter future of the child