Examining Perceptions of Computerized Physician Order Entry in a Neonatal Intensive Care Unit. 2017

Kristyn S Beam, and Megan Cardoso, and Megan Sweeney, and Geoff Binney, and Saul N Weingart
Kristyn Beam, MD, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, Phone: 704.699.4744, Email: kbeam@tuftsmedicalcenter.org.

Computerized provider order entry (CPOE) is a technology with potential to transform care delivery. While CPOE systems have been studied in adult populations, less is known about the implementation of CPOE in the neonatal intensive care unit (NICU) and perceptions of nurses and physicians using the system. To examine perceptions of clinicians before and after CPOE implementation in the NICU of a pediatric hospital. A cross-sectional survey of clinicians working in a Level III NICU was conducted. The survey was distributed before and after CPOE implementation. Participants were asked about their perception of CPOE on patient care delivery, implementation of the system, and effect on job satisfaction. A qualitative section inquired about additional concerns surrounding implementation. Responses were tabulated and analyzed using the Chi-square test. The survey was distributed to 158 clinicians with a 47% response rate for pre-implementation and 45% for post-implementation. Clinicians understood why CPOE was implemented, but felt there was incomplete technical training. The expectation for increased job satisfaction and ability to recruit high-quality staff was high. However, there was concern about the ability to deliver appropriate treatments before and after implementation. Physicians were more optimistic about CPOE implementation than nurses who remained concerned that workflow may be altered. Introducing CPOE is a potentially risky endeavor and must be done carefully to mitigate harm. Although high expectations of the system can be met, it is important to attend to differing expectations among clinicians with varied levels of comfort with technology. Interdisciplinary collaboration is critical in planning a functioning CPOE to ensure that efficient workflow is maintained and appropriate supports for individuals with a lower degree of technical literacy is available.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007363 Intensive Care Units, Neonatal Hospital units providing continuing surveillance and care to acutely ill newborn infants. Neonatal Intensive Care Unit,Neonatal Intensive Care Units,Newborn Intensive Care Unit,Newborn Intensive Care Units,ICU, Neonatal,Neonatal ICU,Newborn ICU,Newborn Intensive Care Units (NICU),ICU, Newborn,ICUs, Neonatal,ICUs, Newborn,Neonatal ICUs,Newborn ICUs
D010820 Physicians Individuals licensed to practice medicine. Physician
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001291 Attitude of Health Personnel Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc. Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes
D001292 Attitude to Computers The attitude and behavior associated with an individual using the computer. Attitude to Computer,Computer, Attitude to,Computers, Attitude to,to Computer, Attitude,to Computers, Attitude
D050316 Medical Order Entry Systems Information systems, usually computer-assisted, that enable providers to initiate medical procedures, prescribe medications, etc. These systems support medical decision-making and error-reduction during patient care. CPOE,Order Entry Systems, Medical,Alert Systems, Medication,Computerized Physician Order Entry,Computerized Physician Order Entry System,Computerized Provider Order Entry,Computerized Provider Order Entry System,Medication Alert Systems,Alert System, Medication,Medication Alert System,System, Medication Alert

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