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Impact of a computerized physician order entry system on nurse-physician collaboration in the medication process.

Abstract：

BACKGROUND:Due to their efficiency and safety potential, computerized physician order entry (CPOE) systems are gaining considerable attention in in-patient settings. However, recent studies have shown that these systems may undermine the efficiency and safety of the medication process by impeding nurse-physician collaboration. OBJECTIVE:To evaluate the effects of a CPOE system on the mechanisms whereby nurses and physicians maintain their collaboration in the medication process. SETTING AND METHODOLOGY: Six internal medicine wards at the Erasmus Medical Centre were included in this study. A questionnaire was used to record nurses' attitudes towards the effectiveness of the former paper-based system. A similar questionnaire was used to evaluate nurses' attitudes with respect to a CPOE system that replaced the paper-based system. The data were complemented and triangulated through interviews with physicians and nurses. RESULTS:Response rates for the analyzed questions in the pre- and post-implementation questionnaires were 54.3% (76/140) and 52.14% (73/140). The CPOE system had a mixed impact on medication work: while it improved the main non-supportive features of the paper-based system, it lacked its main supportive features. The interviews revealed more detailed supportive and non-supportive features of the two systems. A comparison of supportive features of the paper-based system with non-supportive features of the CPOE system showed that synchronisation and feedback mechanisms in nurse-physician collaborations have been impaired after the CPOE system was introduced. CONCLUSION:This study contributes to an understanding of the affected mechanisms in nurse-physician collaboration using a CPOE system. It provides recommendations for repairing the impaired mechanisms and for redesigning the CPOE system and thus for better supporting these structures.

journal_name

Int J Med Inform

journal_title

International journal of medical informatics

authors

Pirnejad H,Niazkhani Z,van der Sijs H,Berg M,Bal R

doi

10.1016/j.ijmedinf.2008.04.001

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

735-44

issue

11

eissn

1386-5056

issn

1872-8243

pii

S1386-5056(08)00047-6

journal_volume

77

pub_type

杂志文章

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