Cited by 142Electronic Health Records SystemsPatient Safety and Medication ErrorsDrug-Induced Adverse Reactions

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A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome

Carspecken, C. William, Sharek, Paul J., Longhurst, Christopher, Pageler, Natalie M.·2013·Pediatrics

DOI 10.1542/peds.2012-3252

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Abstract

Despite advances in electronic medication order entry systems, it has been well established that clinicians override many drug allergy alerts generated by the electronic health record. The direct clinical consequences of overalerting clinicians in a pediatric setting have not been well demonstrated in the literature. We observed a patient in the PICU who experienced complications as a result of an extended series of non–evidence-based alerts in the electronic health record. Subsequently, evidence-based allergy alerting changes were made to the hospital’s system. Incorporating clinical evidence in electronic drug allergy alerting systems remains challenging, especially in pediatric settings.

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Authors: Carspecken, C. W., Sharek, P. J., Longhurst, C., & Pageler, N. M.
Affiliations: Harvard University (US)
Lucile Packard Children's Hospital (US)
Systems Medicine, and
Stanford Medicine (US)
ORCID: Pageler, Natalie M.
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2013-06-01
Volume: 131
Issue: 6
Pages: e1970-e1973
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2012-3252
OpenAlex: W2047955590
Cited by: 142
References: 22
Citations by year: 2026: 9 · 2025: 9 · 2024: 9 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 15 · 2019: 11 · 2018: 8 · 2017: 11 · 2016: 11 · 2015: 17 · 2014: 8 · 2013: 2
FWCI: 21.92
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
Keywords: drug allergy alerts, electronic health records, alarm fatigue, alert override, pediatric intensive care unit, drug safety, patient outcomes
MeSH terms: Child, Preschool, Diagnosis, Differential, Drug Hypersensitivity, Fatigue, Humans, Male, Medication Errors, Practice Patterns, Physicians', Evidence-Based Medicine, Decision Support Systems, Clinical, Medical Order Entry Systems, Electronic Health Records

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A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome

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