Title

Errors and electronic prescribing : a controlled laboratory study to examine task complexity and interruptions effects

Document Type

Journal article

Source Publication

Journal of the American Medical Informatics Association

Publication Date

9-1-2010

Volume

17

Issue

5

First Page

575

Last Page

583

Abstract

Objective: To examine the effect of interruptions and task complexity on error rates when prescribing with computerized provider order entry (CPOE) systems, and to categorize the types of prescribing errors. Design: Two within-subject factors: task complexity (complex vs simple) and interruption (interruption vs no interruption). Thirty-two hospital doctors used a CPOE system in a computer laboratory to complete four prescribing tasks, half of which were interrupted using a counterbalanced design. Measurements: Types of prescribing errors, error rate, resumption lag, and task completion time. Results: Errors in creating and updating electronic medication charts that were measured included failure to enter allergy information; selection of incorrect medication, dose, route, formulation, or frequency of administration from lists and drop-down menus presented by the CPOE system; incorrect entry or omission in entering administration times, start date, and free-text qualifiers; and omissions in prescribing and ceasing medications. When errors occurred, the error rates across the four prescribing tasks ranged from 0.5% (1 incorrect medication selected out of 192 chances for selecting a medication or error opportunities) to 16% (5 failures to enter allergy information out of 32 error opportunities). Any impact of interruptions on prescribing error rates and task completion times was not detected in our experiment. However, complex tasks took significantly longer to complete (F(1, 27)=137.9; p

DOI

10.1136/jamia.2009.001719

Print ISSN

10675027

E-ISSN

1527974X

Publisher Statement

Copyright © 2010 Oxford University Press

Access to external full text or publisher's version may require subscription.

Full-text Version

Publisher’s Version

Recommended Citation

Magrabi, F., Li, S. Y. W., Day, R. O., & Coiera, E. (2010). Errors and electronic prescribing: A controlled laboratory study to examine task complexity and interruptions effects. Journal of the American Medical Informatics Association, 17(5), 575-583. doi: 10.1136/jamia.2009.001719