. Mohammad Reza Afrash; . Shirin Kianersi; . Mohammadkarim Bahadori
Volume 13, Issue 2 , February 2023, , Pages 1-11
Abstract
BACKGROUND: Chemotherapy is a complex, multi‑disciplinary, and error‑prone process. Informationtechnology is being increasingly used in different health care settings with complex ...
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BACKGROUND: Chemotherapy is a complex, multi‑disciplinary, and error‑prone process. Informationtechnology is being increasingly used in different health care settings with complex work proceduressuch as cancer care to enhance the quality and safety of care. In this study, we aimed to developa computerized physician order entry (CPOE) for chemotherapy prescribing in patients with gastriccancer and to evaluate the impact of CPOE on medication errors and order problems.MATERIALS AND METHODS: A multi‑disciplinary team consisting of a chemotherapy council groupand system design and implementation team was formed for chemotherapy process evaluation,requirement analysis, developing computer‑based protocols, and implementation of CPOE. A beforeand after study was conducted to evaluate the impact of CPOE on the chemotherapy process andmedication errors and problem orders. To evaluate the level of end‑user satisfaction, an ISO Norm9241/110 usability questionnaire was chosen for the evaluation.RESULTS: Before the implementation of the CPOE system, 37 medication errors (46.25%) and53 problem orders (66.25%) were recorded for 80 paper‑based chemotherapy prescriptions. Afterimplementation of the CPOE system, 7 (8.7%) medication errors and 6 (7.5%) problem orders wererecorded for 80 CPOE prescriptions. The implementation of CPOE reduced the medication error by37.55% and the problematic order by 58.75%. The results for usability evaluation indicate that theCPOE was within the first class of the ISONORM level rating; this shows that a CPOE is with veryhigh satisfaction and a very high functionality rate.CONCLUSION: Developing a CPOE system significantly improved safety and quality of thechemotherapy process in cancer care settings by reducing the medication error, deleting unnecessarysteps, improving communication and coordination between providers, and use of updatedevidence‑based medicine in direct chemotherapy orders. However, the CPOE system does notprevent all medication errors and may cause new errors. These errors can be human‑related factorsor associated with the design and implementation of the systems.
