Development and impact of a computerized pediatric antiinfective decision support program.

C. J. Mullett, R. S. Evans, John Christenson, J. M. Dean

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

OBJECTIVE: Computerized medical decision support tools have been shown to improve the quality of care and have been cited by the Institute of Medicine as one method to reduce pharmaceutical errors. We evaluated the impact of an antiinfective decision support tool in a pediatric intensive care unit (PICU). METHODS: We enhanced an existing adult antiinfective management tool by adding and changing medical logic to make it appropriate for pediatric patients. Process and outcomes measures were monitored prospectively during a 6-month control and a 6-month intervention period. Mandatory use of the decision support tool was initiated for all antiinfective orders in a 26-bed PICU during the intervention period. Clinician opinions of the decision support tool were surveyed via questionnaire. RESULTS: The rate of pharmacy interventions for erroneous drug doses declined by 59%. The rate of anti-infective subtherapeutic patient days decreased by 36%, and the rate of excessive-dose days declined by 28%. The number of orders placed per antiinfective course decreased 11.5%, and the robust estimate of the antiinfective costs per patient decreased 9%. The type of anti-infectives ordered and the number of antiinfective doses per patient remained similar, as did the rates of adverse drug events and antibiotic-bacterial susceptibility mismatches. The surveyed clinicians reported that use of the program improved their antiinfective agent choices as well as their awareness of impairments in renal function and reduced the likelihood of adverse drug events. CONCLUSIONS: Use of the pediatric antiinfective decision support tool in a PICU was considered beneficial to patient care by the clinicians and reduced the rates of erroneous drug orders, improved therapeutic dosage targets, and was associated with a decreased robust estimate of antiinfective costs per patient. antiinfective agents, decision support systems, drug therapy, medication errors, child, infant.

Original languageEnglish (US)
JournalPediatrics
Volume108
Issue number4
StatePublished - Oct 2001
Externally publishedYes

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Pediatric Intensive Care Units
Pediatrics
Anti-Infective Agents
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Likelihood Functions
Costs and Cost Analysis
Medication Errors
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Process Assessment (Health Care)
Quality of Health Care
Patient Care
Outcome Assessment (Health Care)
Anti-Bacterial Agents
Kidney
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Development and impact of a computerized pediatric antiinfective decision support program. / Mullett, C. J.; Evans, R. S.; Christenson, John; Dean, J. M.

In: Pediatrics, Vol. 108, No. 4, 10.2001.

Research output: Contribution to journalArticle

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