Cited by 74Electronic Health Records SystemsPatient Safety and Medication ErrorsNursing Diagnosis and Documentation

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

PIRNEJAD, H, NIAZKHANI, Z, VANDERSIJS, H, BERG, M, BAL, R·2008·International Journal of Medical Informatics

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.

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Crossref · 10.1016/j.ijmedinf.2008.04.001

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    “research suggests that technology may lead to new uncertainties and risks for patient safety through disrupting established work patterns, creating new risks in practice, and encouraging workarounds.”

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Authors
PIRNEJAD, H., NIAZKHANI, Z., VANDERSIJS, H., BERG, M., & BAL, R.
Affiliations
Erasmus MC (NL)
Corresponding author
PIRNEJAD, H
Venue
International Journal of Medical Informatics
Publisher
Elsevier BV
Published
2008-11
Volume
77
Issue
11
Pages
735-744
ISSN
1386-5056 (ISSN-L)
OpenAlex
W1969461106
Cited by
73
References
32
Citations by year
2026: 1 · 2022: 5 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 13 · 2013: 4 · 2012: 5
FWCI
19.79
Type
journal article
Language
en
Open access
closed
Locations
  • International Journal of Medical Informatics (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
Keywords
computerized physician order entry, nurse-physician collaboration, medication process, internal medicine ward, nurses' attitudes, feedback mechanisms, synchronization, drug safety, inpatient medication management
MeSH terms
Adult, Attitude of Health Personnel, Attitude to Computers, Communication Barriers, Cooperative Behavior, Cross-Sectional Studies, Drug Therapy, Computer-Assisted, Pharmaceutical Preparations, Female, Humans, Male, Medication Errors, Middle Aged, Safety Management, Physician-Nurse Relations, Decision Support Systems, Clinical, Medical Order Entry Systems

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