Computer order entry system ups antimicrobial policy compliance

(HealthDay)—Use of a computerized physician order entry (CPOE) system can improve compliance with antimicrobial restriction policies, according to a study published online Nov. 16 in the Journal of Pharmacy Practice and Research.

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 three 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.

The researchers found that surveillance improved from 10.5 to 65 to 100 percent from P1 to P2 to P3, respectively, after introduction of CM via a CM reporting module (P < 0.0001). Compliance improved from 6 to 55 to 76 percent from P1 to P2 to P3, respectively (P < 0.0001). There was improvement in documentation of a clear/complete indication from 10 to 56.5 to 76.5 percent from P1 to P2 to P3, respectively (P < 0.0001). Improvement was also seen in approvals obtained within 24 hours of prescribing (61.9 to 96.9 to 100 percent 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."