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Dispensing Drug Dosage To Children Through Computers

and drug dilutions to help doctors avoid overdosing and under-dosing.

For the study, researchers compared handwritten and calculator-generated orders before and after the online calculator was put into use. Twenty-seven percent of handwritten orders were incorrect, with an error rate of 45 errors per every 100 written orders. By contrast, 94 percent of the calculator-generated orders were correct, with an error rate of 6 per 100. The most frequent errors in handwritten orders were wrong dosage and wrong concentration, both of which are considered high-risk errors. None of the calculator-generated orders contained such errors.

To measure the effect of the computerized provider order entry system (CPOE) on pediatric chemotherapy orders, researchers compared 1,259 handwritten orders to 1,116 electronic orders, finding that chemotherapy orders generated with CPOE were less likely to contain dose miscalculations and had fewer omissions of cumulative doses, which is the maximum dose of a medication that can be safely given to a patient over a specific time period. Computerized orders were also less likely to have incomplete nurse safety checklists. Researchers estimate that the computerized system prevented 17 to 18 such errors per every 100 chemotherapy orders.

"Most of these errors may have been caught by pharmacists or nurses before they could have hurt a patient," emphasized Lehmann, "But we wanted to prevent providers from making errors in the first place because some of them may reach the patient."

The chemotherapy order system uses calculators that automatically adjust dosage to the patient's age and weight, thus eliminating the need for complex calculations and reducing the risk of calculation errors. The program reduces the need for handwritten information and free text by forcing providers to make selections from a dropdown menu.

On a cautionary note, researchers found the risk for mismatching medication or
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