ArticleBMC medical informatics and decision making2011
Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model.
Article in BMC medical informatics and decision making, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Use of Computerized Physician Order Entry with Clinical Decision Support to Prevent Dose Errors in Pediatric Medication Orders: A Systematic Review.Paediatric drugs · 2024Pooled it
- Factors contributing to medication errors made when using computerized order entry in pediatrics: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2018Pooled it
- The impact of patient information on prescribing errors: Insights from pharmaceutical interventions.Exploratory research in clinical and social pharmacy · 2025Article
- Medication errors related to high-alert medications in a paediatric university hospital - a cross-sectional study analysing error reporting system data.BMC pediatrics · 2023Article
- Improving medication safety in a paediatric hospital: a mixed-methods evaluation of a newly implemented computerised provider order entry system.BMJ health & care informatics · 2023Observational
- Association between neonatal intensive care unit medication safety practices, adverse events, and death.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy.BMC medical informatics and decision making · 2020Article
- Interventions to reduce medication errors in neonatal care: a systematic review.Therapeutic advances in drug safety · 2018Review
- Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients.Journal of the American Medical Informatics Association : JAMIA · 2014Article
- Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients.Journal of the American Medical Informatics Association : JAMIA · 2014Article
- Computerized clinical decision support for medication prescribing and utilization in pediatrics.Journal of the American Medical Informatics Association : JAMIAReview
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is well known that the information requirements necessary to safely treat children with therapeutic medications cannot be met with the same approaches used in adults. Over a 1-year period, Duke University Hospital engaged in the challenging task of enhancing an established computerized provider order entry (CPOE) system to address the unique medication dosing needs of pediatric patients.
methodsAn advanced dosing model (ADM) was designed to interact with our existing CPOE application to provide decision support enabling complex pediatric dose calculations based on chronological age, gestational age, weight, care area in the hospital, indication, and level of renal impairment. Given that weight is a critical component of medication dosing that may change over time, alerting logic was added to guard against erroneous entry or outdated weight information.
resultsPediatric CPOE was deployed in a staggered fashion across 6 care areas over a 14-month period. Safeguards to prevent miskeyed values became important in allowing providers the flexibility to override the ADM logic if desired. Methods to guard against over- and under-dosing were added. The modular nature of our model allows us to easily add new dosing scenarios for specialized populations as the pediatric population and formulary change over time.
conclusionsThe medical needs of pediatric patients vary greatly from those of adults, and the information systems that support those needs require tailored approaches to design and implementation. When a single CPOE system is used for both adults and pediatrics, safeguards such as redirection and suppression must be used to protect children from inappropriate adult medication dosing content. Unlike other pediatric dosing systems, our model provides active dosing assistance and dosing process management, not just static dosing advice.
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