Characteristics of clinical decision support alert overrides in an electronic prescribing system at a tertiary care paediatric hospital
Abstract
Context: Electronic prescribing (EP) systems are advocated as a solution to minimise medication errors. Benefits in patient safety are often as a result of some clinical decision support (CDS) within the system. Objective: To study the characteristics of the CDS alerts generated within a commercially available EP system in use at a tertiary care paediatric hospital in the UK. Methods: Retrospective review and characterisation of CDS alerts recorded in the EP system over 1 year. Results: A total of 16 182 conflict alerts were recorded when ordering 26 836 items, of which 3507 (13 alerts per 100 prescription orders (95% confidence interval, 12.8 to 13.6)) were visible to the user. Eighty nine percent (3119/3507) of all visible alerts were overridden by the user at point of prescribing. Drug-allergy conflict alerts were the most accepted, and exact drug duplication alerts the least. Conclusion: We found a high incidence of alert override, which is undesirable but consistent with that reported in the literature. The results suggest that the underlying algorithms for alert generation in many EP systems are not specific and need to be reviewed.
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- Authors
- Jani, Y. H., Barber, N., & Wong, I. C. K.
- Affiliations
- University of London (GB)
- Corresponding author
- Jani, Yogini Hariprasad
- Venue
- International Journal of Pharmacy Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-05-23
- Volume
- 19
- Issue
- 5
- Pages
- 363-366
- ISSN
- 0961-7671 (ISSN-L)
- 2042-7174
- OpenAlex
- W1952748834
- Cited by
- 44
- References
- 17
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 7 · 2012: 3
- FWCI
- 6.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- International Journal of Pharmacy Practice (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- The HKU Scholars Hub (University of Hong Kong) (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 › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- clinical decision support alerts, alert override, electronic prescribing, children's hospitals, medication errors, drug allergy alerts, patient safety
- MeSH terms
- Hospitals, Pediatric, Humans, Medication Errors, Decision Support Systems, Clinical, Electronic Prescribing
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