Preventing provider errors: online total parenteral nutrition calculator

• HIT Description: decision support Ð clinical guidelines, CPOE More info...
  
• Purpose of Study: evaluate the effectiveness of the system (total parenteral nutrition order entry system Ð TPN-Calculator) in error reduction and assess its acceptance by ordering providers
  
• Years of study: 2001
  
• Study Design: pre-post
  
• Outcomes: changes in quality of care & patient safety; efficiency & productivity;
  

• Settings: neonatal intensive care unit of the Johns Hopkins Hospital
• Intervention: the number of parenteral nutrition orders and the frequency and type of errors were assessed before and after implementation of the TPN-Calculator. Prescribers, pharmacists and nurses were also surveyed online.
• Evaluation Method: pharmacist-detected errors, online survey
• Description: TPN-Calculator is an online TPN order entry system that uses a routine web development tool (Macromedia Cold fusion) and that performs all necessary fluid and component calculations on the basis of provider input via an Internet browser. It also contains nutritional guidelines, an osmolality calculator and 62 rule-based alerts and reminders
• Strategy: Residents received a 10-minute training before initial use
• Quality of Care and Patient Safety Outcome: There was a 61% reduction in errors between the control and first intervention period and an 89% reduction in errors in the second intervention period.
• Changes in efficiency and productivity: Providers felt that the TPN Calculator was easier to use than the paper form and that it protected against errors