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Introduction
Computerized provider order entry (CPOE) is a terminology used to describe the process through which providers enter and send treatment instructions, especially with hospitalized patients. The commonly inputted treatment instructions include medications, admission, referral, laboratory, procedure, and radiology orders. The system is computer-based, and thus it replaces the traditional practice of using paperwork to record the mentioned information.
CPOE systems also allow users to keep online medication administration records. Additionally, through CPOE, users can review any changes that other personnel might have made on a given order. The system also creates safety alerts in case an unsafe order is entered, such as duplicate drug-therapy on a certain patient. Besides, CPOE systems offer clinical decision support, which allows users to use inexpensive alternatives or make choices that are in line with the established hospital guidelines.
The purpose of this topic is to ensure patient safety, efficiency, and outcomes. CPOE system plays a central role in the reduction of medication errors, thus improving patient safety. The impacts of CPOE on healthcare and specifically nursing practice are manifold. First, medication errors are reduced significantly or eliminated. According to Rahimi, Kazemi, Moghaddasi, Arjmandi Rafsanjani, and Bahoush (2018), medication errors are costly, and they can cause irreparable harm to patients.
Therefore, CPOE improves patient safety and outcomes by eliminating medication errors. In addition, CPOE allows health care facilities to function effectively and provide timely and quality care services. For instance, such facilities can get laboratory results and medications within a short period, thus saving time and resources. Similarly, the use of CPOE improves reimbursements for health care facilities. For example, some orders require pre-approvals by insurance companies and the CPOE system flags such orders, and thus hospitals have reduced denied insurance claims. This aspect affects the delivery of care positively because hospitals have the monetary resources that are needed for the provision of quality care services.
Example of Computerized Provider Order Entry
One example of CPOE is the inpatient computerized provider order entry. In nursing practice, inpatient CPOE plays the central role in minimizing medication errors. In the conventional way of giving patient instructions, doctors have been accused of illegible handwriting, which may easily lead to medication errors (Khanna & Yen, 2014). However, with the inpatient CPOE, the instructions given are clear, and thus the probability of a nurse making an error is almost zero.
This technology is designed to mirror the conventional workflow of the paper chart, which is common in health care facilities that have not adopted CPOE. The system is integrated with e-prescribing technologies to alert nurses in case a drug-related error has been made (Kuperman et al., 2007). For instance, in case double entry for a given drug has been made, the system will flag the input and alert users. Additionally, if a patient has known and documented allergies to a certain drug, the system will inform its users.
The inpatient CPOE system has a variety of features. The first feature is ordering, which allows physicians to enter their orders into the system using laptops, workstations, or secure mobile gadgets. Therefore, all departments in a health care facility receive these orders, and this aspect leads to improved response time coupled with addressing scheduling problems (Khanna & Yen, 2014). Additionally, orders placed from one point and sent to all departments prevent conflict with existing orders.
The second feature is the patient-centered decision support. The inpatient CPOE is integrated with electronic health records (EHR) and clinical decision support systems (CDSS) to provide updated patient information (Khanna & Yen, 2014). Besides, the system provides available patient medical history to allow better decision making on the type and nature of care that is appropriate for a given patient. Additionally, the system uses evidence-based clinical guidelines to assist users in making the right decisions. As such, outcomes improve tremendously, by ensuring that patients receive personalized care supported with the appropriate decisions.
Patient safety is another feature found in the inpatient CPOE. Through the system, nurses and doctors can identify patients in real time, review drug dosage, and establish the presence of drug-related complications that a patient may have by receiving the recommended medications (Kuperman et al., 2007). The system also identifies the existence of allergies and treatment conflicts, thus improving patient safety and outcomes.
Another feature of this system is an intuitive user interface that mirrors the paper-based entry forms. Therefore, new users learn how to use the system easily. Security features are created following federal and state guidelines to ensure that patients information is protected. As such, patient information can only be accessed by authorized personnel. The portability feature allows providers to use the system from anywhere using various devices, such as secure tablets, laptops, and other devices. The system also has a management feature to generate reports, which when analyzed, can indicate whether changes in personnel, inventory, or productivity are needed. Finally, the system has a billing feature to support the required charges for services offered.
Personal Experience
The hospital where I worked as a nurse for the first time did not have a CPOE system. I noted that medication errors were common because the communication process was paper-based and doctors handwriting would be illegible in some cases, and thus nurses were likely to make mistakes. However, later I joined another large heath care facility that had incorporated CPOE systems. Immediately after I started working, I noticed several changes and improvements as opposed to my previous workplace. I noted that different health care providers would access and view a patients records remotely at the same time.
One of the interesting aspects of this system was the ability to send alerts the moment drug-related problems were noticed (Rahimi et al., 2018). This aspect was a major shift from my previous workplace where patients would be exposed to medication errors. As a nurse, my experience with CPOE has been a journey of ensuring patient safety. Every time I receive instructions from doctors, they are clear and concise, and I have never made a medication error since I started using this system. All hospitals without CPOE systems, as my first workplace, can improve patient outcomes and safety by embracing technology for better healthcare services.
Conclusion
CPOE systems allow users to enter treatment information remotely using laptops, secure mobile devices, and other gadgets. The purpose of such systems is to ensure patient safety by reducing the chances of medication errors. CPOE systems have affected nursing practice positively. Medication errors are classified among the major causes of patient mortality and morbidity in the US. Therefore, these systems have addressed an important problem in nursing practice. My experience with CPOE has been exciting, and this newfound insight and experience will continue to influence my nursing care positively. It feels nice to know that my patients are secure and they receive timely and quality care services.
References
Khanna, R., & Yen, T. (2014). Computerized physician order entry: Promise, perils, and experience. The Neurohospitalist, 4(1), 26-33.
Kuperman, G. J., Bobb, A., Payne, T. H., Avery, A. J., Gandhi, T. K., Burns, G., Classen, D. C., & Bates, D. W. (2007). Medication-related clinical decision support in computerized provider order entry systems: A review. Journal of the American Medical Informatics Association, 14(1), 29-40.
Rahimi, R., Kazemi, A., Moghaddasi, H., Arjmandi Rafsanjani, K., & Bahoush, G. (2018). specifications of computerized provider order entry and clinical decision support systems for cancer patients undergoing chemotherapy: A systematic review. Chemotherapy, 63(3), 162-171.
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