Computerized Physician Order Entry (CPOE) in pediatric and neonatal intensive care: Recommendations how to meet clinical requirements

Appl Clin Inform. 2012 Feb 15;3(1):64-79. doi: 10.4338/ACI-2011-08-RA-0051. Print 2012.

Abstract

Objective: To identify and summarize the requirements of an optimized CPOE application for pediatric intensive care.

Methods: We analyzed the medication process and its documentation in the pediatric and neonatal intensive care units (PICU/NICU) of two university hospitals using workflow analysis techniques, with the aim of implementing computer-supported physician order entry (CPOE).

Results: In both PICU/NICU, we identified similar processes that differed considerably from adult medication routine. For example, both PICU/NICU prepare IV pump syringes on the ward, but receive individualized ready-to-use mixed IV bags for each patient from the hospital pharmacy on the basis of a daily order. For drug dose calculation, both PICU/NICU employ electronic calculation tools that are either incorporated within the CPOE system, or are external modules invoked via interface.

Conclusion: On the basis of this analysis, we provide suggestions to optimize CPOE applications for use in the pediatric and neonatal intensive care unit in the form of three catalogues of desiderata for drug order entry support.

Keywords: Inpatient; clinical documentation and communications; critical care and emergency; inpatient CPOE; intensive care; neonatology; pediatrics; requirements analysis and design; workflow.