Clinical Pharmacists’ Development and Quality Assurance of Medication Orders in a Computerized Order Entry System

This study is to evaluate the development process of medication orders in a computer system for a soon to be opened women and children’s hospital. To determine which therapeutic categories include medications that may have less defined dosing regimens. Medication orders were built into the Computerized Order Entry (COE) system and evaluated individually by pharmacists from various clinical practice backgrounds. These pre-constructed, quick entry medication orders will present common medication attributes in a drop down menu when a physician searches for a desired medication. The medication orders involved 14 components that were evaluated by the clinical pharmacists. For a medication order to be considered complete, it had to be reviewed by two consecutive pharmacists who did not see any further necessary changes to the previous pharmacist’s medication order. The number of pharmacists required to have 3 pharmacists in consecutive agreement on the medication order ranged from 3 to 9 pharmacists. The therapeutic group that required the most pharmacist evaluations to reach consensus was antimicrobials and the therapeutic category that required the least amount of pharmacist reviews was antidiabetic medications. After 6 pharmacists had reviewed the medication orders, 25.7% of the antimicrobials were without three consecutive pharmacist approvals. The most common change made after 5 reviews were completed was adjustments to age and weight filters. As there was variability in the number of pharmacist reviews required to reach completion, greater attention to detail should be considered in therapeutic areas that required more evaluations to reach a consensus.