| Summary: | 碩士 === 亞洲大學 === 健康產業管理學系健康管理組碩士在職專班 === 100 === Background：Institute of Medicine (IOM) proposed the utilization of medical information technology in 2004, as one of means to promote the patient safety. The employment of medical information technology not only could provide in-time interpretation information to medical professionals, but also avoid near miss events. Therefore, this research intends to analyze the effects of implementing computerized physician order entry (CPOE) on the near miss improvement of physicians’ prescription.
Methods：The study used One-Group Pretest-Posttest Design to investigate the before-and-after near miss events at counterpart months, including redundant medication, frequency of inappropriate, improper dosage, name of the medicine errors, the computer entry errors, the wrong route of administration, inappropriate prescription, and the wrong drugs combination. A total of 1,669 near miss cases were collected out of 3,450,185 prescriptions from January, 2009 till December, 2010, with implementation of CPOE on June to August, 2009. The SAS software was used as statistical tools for descriptive and inferential analyses.
Results：The overall near miss rate dropped from 0.0087% to 0.0049%, with 44.8% improvement (p<0.0001). Most near miss prescription have significant improvement except for the wrong route of administration (p=0.8847), inappropriate prescription (p=0.1549), and the wrong drugs combination (p=0.2219). In addition, the influencing factors on physicians’ prescriptions are doctor’s gender (p=0.0378), doctor specialization (p=0.0002), the working conditions difference (p<0.0001), the work time interval (p<0.0001), and near miss occurrence interval (p<0.0001). The study also found the implementation of CPOE can remove the impacts of different the work time interval and outpatient/emergency department shift on near miss occurrence.
Conclusion：Efforts to implementation the CPOE system will be helpful to reduce the near miss rate of the prescription. Meanwhile, the system can remove the impacts of different the work time interval and outpatient/emergency department shift on near miss occurrence.
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