Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow

Alison K. Chapman, Christoph U. Lehmann, Pamela K. Donohue, Susan W. Aucott

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: The study objective was to determine if computerized provider order entry (CPOE) systems impaired or enhanced workflow in the neonatal intensive care unit (NICU) by comparing the timing of administration of the first dose of antibiotics before and after CPOE system implementation. Methods: We conducted a pre-post intervention comparative study of the length of time between admission and administration of initial antibiotics in neonates before and after a CPOE system was implemented. Clinical information and timing of antibiotic administration were collected on all inborn infants, who were admitted to the NICU in the first 4. h of life and treated with antibiotics, for one year prior to the implementation of computerized order entry and for one year after the implementation. Results: Infants admitted to the NICU were similar in both periods (mean birth weight 2183. g vs. 2091. g, gestational age 33.3 weeks vs. 33.0 weeks). There was no significant difference in mean length of time from admission to antibiotic administration in the pre-CPOE group (131. min [CI 124-139]) compared to the post-CPOE group (125. min [CI 116-133]) (p=0.07). The mean time to pharmacy verification for a subset of patients was significantly shorter for patients in the post-CPOE group (61 ± 58. min) compared to the pre-CPOE group (88 ± 76. min) (p=<0.001). Conclusions: While the introduction of a CPOE system in the NICU did not significantly improve antibiotic administration times, the timeliness of an important aspect of the medication process, time to pharmacy verification, was improved. These findings imply other factors are impeding workflow. Further studies are needed to evaluate how CPOE systems combined with patient care activities affect workflow and overall patient care.

Original languageEnglish (US)
Pages (from-to)291-295
Number of pages5
JournalInternational Journal of Medical Informatics
Volume81
Issue number5
DOIs
StatePublished - May 1 2012
Externally publishedYes

Fingerprint

Medical Order Entry Systems
Workflow
Neonatal Intensive Care Units
Anti-Bacterial Agents
Patient Care
Birth Weight
Gestational Age
Newborn Infant

Keywords

  • Computerized provider order entry
  • Neonatal intensive care
  • Workflow

ASJC Scopus subject areas

  • Health Informatics

Cite this

Implementation of computerized provider order entry in a neonatal intensive care unit : Impact on admission workflow. / Chapman, Alison K.; Lehmann, Christoph U.; Donohue, Pamela K.; Aucott, Susan W.

In: International Journal of Medical Informatics, Vol. 81, No. 5, 01.05.2012, p. 291-295.

Research output: Contribution to journalArticle

@article{1e6a5c2d6836477cbb2d8bd5a5967858,
title = "Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow",
abstract = "Objective: The study objective was to determine if computerized provider order entry (CPOE) systems impaired or enhanced workflow in the neonatal intensive care unit (NICU) by comparing the timing of administration of the first dose of antibiotics before and after CPOE system implementation. Methods: We conducted a pre-post intervention comparative study of the length of time between admission and administration of initial antibiotics in neonates before and after a CPOE system was implemented. Clinical information and timing of antibiotic administration were collected on all inborn infants, who were admitted to the NICU in the first 4. h of life and treated with antibiotics, for one year prior to the implementation of computerized order entry and for one year after the implementation. Results: Infants admitted to the NICU were similar in both periods (mean birth weight 2183. g vs. 2091. g, gestational age 33.3 weeks vs. 33.0 weeks). There was no significant difference in mean length of time from admission to antibiotic administration in the pre-CPOE group (131. min [CI 124-139]) compared to the post-CPOE group (125. min [CI 116-133]) (p=0.07). The mean time to pharmacy verification for a subset of patients was significantly shorter for patients in the post-CPOE group (61 ± 58. min) compared to the pre-CPOE group (88 ± 76. min) (p=<0.001). Conclusions: While the introduction of a CPOE system in the NICU did not significantly improve antibiotic administration times, the timeliness of an important aspect of the medication process, time to pharmacy verification, was improved. These findings imply other factors are impeding workflow. Further studies are needed to evaluate how CPOE systems combined with patient care activities affect workflow and overall patient care.",
keywords = "Computerized provider order entry, Neonatal intensive care, Workflow",
author = "Chapman, {Alison K.} and Lehmann, {Christoph U.} and Donohue, {Pamela K.} and Aucott, {Susan W.}",
year = "2012",
month = "5",
day = "1",
doi = "10.1016/j.ijmedinf.2011.12.006",
language = "English (US)",
volume = "81",
pages = "291--295",
journal = "International Journal of Medical Informatics",
issn = "1386-5056",
publisher = "Elsevier Ireland Ltd",
number = "5",

}

TY - JOUR

T1 - Implementation of computerized provider order entry in a neonatal intensive care unit

T2 - Impact on admission workflow

AU - Chapman, Alison K.

AU - Lehmann, Christoph U.

AU - Donohue, Pamela K.

AU - Aucott, Susan W.

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Objective: The study objective was to determine if computerized provider order entry (CPOE) systems impaired or enhanced workflow in the neonatal intensive care unit (NICU) by comparing the timing of administration of the first dose of antibiotics before and after CPOE system implementation. Methods: We conducted a pre-post intervention comparative study of the length of time between admission and administration of initial antibiotics in neonates before and after a CPOE system was implemented. Clinical information and timing of antibiotic administration were collected on all inborn infants, who were admitted to the NICU in the first 4. h of life and treated with antibiotics, for one year prior to the implementation of computerized order entry and for one year after the implementation. Results: Infants admitted to the NICU were similar in both periods (mean birth weight 2183. g vs. 2091. g, gestational age 33.3 weeks vs. 33.0 weeks). There was no significant difference in mean length of time from admission to antibiotic administration in the pre-CPOE group (131. min [CI 124-139]) compared to the post-CPOE group (125. min [CI 116-133]) (p=0.07). The mean time to pharmacy verification for a subset of patients was significantly shorter for patients in the post-CPOE group (61 ± 58. min) compared to the pre-CPOE group (88 ± 76. min) (p=<0.001). Conclusions: While the introduction of a CPOE system in the NICU did not significantly improve antibiotic administration times, the timeliness of an important aspect of the medication process, time to pharmacy verification, was improved. These findings imply other factors are impeding workflow. Further studies are needed to evaluate how CPOE systems combined with patient care activities affect workflow and overall patient care.

AB - Objective: The study objective was to determine if computerized provider order entry (CPOE) systems impaired or enhanced workflow in the neonatal intensive care unit (NICU) by comparing the timing of administration of the first dose of antibiotics before and after CPOE system implementation. Methods: We conducted a pre-post intervention comparative study of the length of time between admission and administration of initial antibiotics in neonates before and after a CPOE system was implemented. Clinical information and timing of antibiotic administration were collected on all inborn infants, who were admitted to the NICU in the first 4. h of life and treated with antibiotics, for one year prior to the implementation of computerized order entry and for one year after the implementation. Results: Infants admitted to the NICU were similar in both periods (mean birth weight 2183. g vs. 2091. g, gestational age 33.3 weeks vs. 33.0 weeks). There was no significant difference in mean length of time from admission to antibiotic administration in the pre-CPOE group (131. min [CI 124-139]) compared to the post-CPOE group (125. min [CI 116-133]) (p=0.07). The mean time to pharmacy verification for a subset of patients was significantly shorter for patients in the post-CPOE group (61 ± 58. min) compared to the pre-CPOE group (88 ± 76. min) (p=<0.001). Conclusions: While the introduction of a CPOE system in the NICU did not significantly improve antibiotic administration times, the timeliness of an important aspect of the medication process, time to pharmacy verification, was improved. These findings imply other factors are impeding workflow. Further studies are needed to evaluate how CPOE systems combined with patient care activities affect workflow and overall patient care.

KW - Computerized provider order entry

KW - Neonatal intensive care

KW - Workflow

UR - http://www.scopus.com/inward/record.url?scp=84859161628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859161628&partnerID=8YFLogxK

U2 - 10.1016/j.ijmedinf.2011.12.006

DO - 10.1016/j.ijmedinf.2011.12.006

M3 - Article

C2 - 22226728

AN - SCOPUS:84859161628

VL - 81

SP - 291

EP - 295

JO - International Journal of Medical Informatics

JF - International Journal of Medical Informatics

SN - 1386-5056

IS - 5

ER -