Table 3. Pediatric studies included in a recent Cochrane review (33), on CPOE, unit-dose systems with barcode scanners, and pharmacists on wards.
Study | Design | Study setting | Endpoint | Result | ||
---|---|---|---|---|---|---|
Electronic prescribing systems | Intervention | Control | ||||
King 2003 (e19) | Retrospective before/after study | I: 2 general wards C: 1 general ward, 2 surgical ward 36103 patients in total, USA | Medication errors per 1000 patient days | Before: 4.48 After: 3.13 | Before: 4.80 After: 5.19 | p < 0.001 |
Walsh 2008 (e20) | Before/after study | I: General wards, surgical ward, PICU, NICU C: none Total sample of 627 patients, USA | Serious medication errors that reached the patient, per 1000 patient days | Before: 23.1 After: 20.6 | - | IRR (95% CI 0.69 to 1.78) |
Unit-dose system with barcode scanner (BCMA) | Intervention | Control | ||||
Moriss 2009 (36) | Prospective before/after study | I: NICU C: not reported 958 patients in total, USA | Adverse drug reactions that are affected by the intervention as expected, per 1000 doses | Before: 0.86 After: 0.43 | - | p = 0.008 |
Pharmacist on ward | Intervention | Controlphar | ||||
Kaushal 2008 (38) | Prospective before/after study | I: General ward (part time), surgical ward (part time), PICU (full time) C: general ward, surgical ward, cardiac-intensive ward 4863 patients in total, USA | Serious medication errors per 1000 patient days | General wards | ||
Before: 8 After: 9 | Before: 7 After: 8 | p = 0.78 | ||||
Surgical wards | ||||||
Before: 7After: 9 | Before: 8 After: 10 | p = 0.89 | ||||
PICU | Cardiac-intensive | |||||
Before: 29 After: 6 | Before: 20 After: 30 | p < 0.01 | ||||
Zhang 2012 (e28) | Randomized controlled study | Patients with neurological disorders, respiratory disorders, or digestive disorders, 150 patients in total, China | Hospital stay in days | 7.33 ± 3.52 | 9.06 ± 5.47 | p = 0.02 |
CPOE, computerized physician order entry; I, intervention; C, control; NICU, neonatal intensive care unit; PICU, pediatric intensive care unit; IRR, incidence rate ratio; 95% CI, 95% confidence interval