Physician Order Entry

Physician Order Entry

Physician order entry (POE) is a system in which the physician directly enters his or her own medication orders into a computerized system. That information is communicated to the pharmacy directly rather than being processed by a unit secretary, then the pharmacy, and then the nurse. In one study researchers found a remarkable decrease in the amount of time it takes to process a medication order using a POE; before POE, it took 41.2 minutes for an order to go from being placed to the nurse receiving the information, after it was 27 seconds (Stone, Smith, Shaft, Nelson, & Money, 2009). No nurse at the bedside can argue the need for technologies that make care more efficient, but POE also makes a dent in prescription errors.

How many nurses have looked at chicken scratch on a page and wondered what in the world that was supposed to mean? Using POE, there is no question because the orders are placed directly into a computer, no chicken scratch required. One review of 12 previous studies showed that there was a significant decrease in prescription errors using POE, however, that did not translate into decrease mortality in the patient population (Longhurst, et al., 2010). Another significant downside to POE is that ancillary staff may lose positions as the prescription placement systems are streamlined (Stone, Smith, Shaft, Nelson, & Money, 2009). One has to consider the benefits of each new technology for both positives and negatives, until more research is done, POE remains a wonderful idea that could revolutionize nursing care.

References

Longhurst, C. A., Paraset, L., Sandborg, C. L., Widen, E., Sullivan, J., Hahn, J. S., et al. (2010). Decrease in hospital-wide mortality after implemention of a computerized physician order entry systgem. Pediatrics, 126(1), 14-21. doi:10.1016/j/jamcollsurg.2009.01.042

Stone, W. M., Smith, B. E., Shaft, J. D., Nelson, R. D., & Money, S. R. (2009). Impact of a computerized order-entry system. Journal of American College of Surgeons, 2008(5), 960-969.