HealthDay News — According to a study published in the Journal of Pharmacy Practice and Research, the use of a computerized physician order entry (CPOE) system can improve compliance with antimicrobial restriction policies.

Julie Metcalfe, from Frankston Hospital in Australia, and colleagues compared the performance of an electronic antimicrobial approval system (EAAS) and CPOE system for surveillance of restricted antimicrobials and compliance with antimicrobial restriction policy. 

They retrospectively recruited general medical and surgical patients prescribed restricted antimicrobials over 3 defined periods: period one (P1) used Guidance DS (GDS; an EASS) plus National Inpatient Medication Chart; period two (P2) used GDS plus Cerner Millennium (CM; a CPOE system); and period three (P3) used CM alone. One hundred medical and 100 surgical restricted antimicrobial orders were obtained for each period.

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The researchers found that surveillance improved from 10.5 to 65 to 100% from P1 to P2 to P3, respectively, after introduction of CM via a CM reporting module (P<.0001). 

Compliance improved from 6 to 55 to 76% from P1 to P2 to P3, respectively (P<.0001). There was improvement in documentation of a clear/complete indication from 10 to 56.5 to 76.5% from P1 to P2 to P3, respectively (P<.0001). Improvement was also seen in approvals obtained within 24 hours of prescribing (61.9 to 96.9 to 100% from P1 to P2 to P3, respectively).

“In summary, the combination of CPOE plus EAAS, compared with EAAS alone, improved both surveillance of restricted antimicrobials and compliance with policy, but neither was optimized,” the authors write. “In contrast, CPOE alone, with customization, optimizes surveillance and significantly improves compliance. CPOE greatly enhances the stewardship process by facilitating timely review and intervention, and improvement in efficiency.”


Metcalfe J, et al. “Impact Of The Introduction Of Computerised Physician Order Entry (CPOE) On The Surveillance Of Restricted Antimicrobials And Compliance With Policy”. Journal of Pharmacy Practice and Research. 2016. doi: 10.1002/jppr.1227. [Epub ahead of print]

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