This study presents a prediction-based approach to determine thresholds for a medication alert in a computerized physician order entry. Traditional static thresholds can sometimes lead to physician's alert fatigue or overlook potentially excessive medication even if the doses are belowthe configured threshold. To address this problem, we applied a random forest algorithm to develop a prediction...

OBJECTIVE To develop and evaluate an electronic dashboard of hospital-wide electronic health record medication alerts for an alert fatigue reduction quality improvement project. METHODS We used visual analytics software to develop the dashboard. We collaborated with the hospital-wide Clinical Decision Support committee to perform three interventions successively deactivating clinically irrele...

Delivering useful clinical decision support to providers who are ordering high risk drugs for high risk patients is imperative for safe pharmacotherapy. This paper presents a focused electronic clinical decision support intervention designed to decrease the risk of corrected QT interval (QTc) related adverse drug events in a high risk patient population. Results showed that a customized alert c...

The inappropriate and over-prescribing of medication is an area of nursing fraught with legal and ethical considerations. It can lead to people being chemically restrained and must only be used in exceptional situations. Therapeutic alternatives should take precedent. This article reviews studies on chemical restraint that show high levels of neuroleptic drug prescribing, including pro re nata ...

OBJECTIVE We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. DESIGN Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy aler...

Objective: We sought to determine the frequency and type of decision support alerts by location and ordering provider role during Computerized Provider Order Entry (CPOE) medication ordering. Using these data we adjusted the decision support tools to reduce the number of alerts. Design: Retrospective analyses were performed of dose range checks (DRC), drug-drug interaction and drug-allergy aler...

OBJECTIVE To evaluate the incidence of duplicate medication orders before and after computerized provider order entry (CPOE) with clinical decision support (CDS) implementation and identify contributing factors. DESIGN CPOE with duplicate medication order alerts was implemented in a 400-bed Northeastern US community tertiary care teaching hospital. In a pre-implementation post-implementation ...