Assessing the Medication Ordering Process:Are We Complying with Our Own Medication Policy?

Purpose: This study was conducted to measure physician compliance in adhering to defined policies and procedures when ordering medications through Computer Physician Order Entry (CPOE). Specifically, assessment of physician utilization of the specified calculator to compute appropriate dosing was performed.

Methods: This is a retrospective review of orders obtained for patients less than 14 years old. A total of 1,275 orders were reviewed during a 12 month period. Electronic medical records were utilized to identify essential data. The information was transcribed to a collection tool where documentation included: medication name, priority of order, and ordering practitioner with corresponding service.  

Results: The data revealed 51% compliance by pediatric physicians to the prescribing policy. Consequently, the pediatric medical staff was educated on the importance of abiding to the institution’s policies and procedures. Compliance increased to an average of 90% monthly following presentation of results and extensive education. Several concerns were identified that will be targeted to improve the prescribing medication process.  The policy will be updated to exempt vaccines from requiring calculation based dosing. Monthly performance improvement data will continue to be collected with an annual discussion on outcomes with pediatric medical staff. Pharmacists continue to educate physicians on adhering to the dose calculator for order entry. All these initiatives will ultimately improve patient medication safety.

Conclusion: Since changes were enacted, compliance has averaged 90% monthly. The medication policy will be reviewed yearly to reflect any change to improve patient safety.