A Clinical Case of Electronic Health Record Drug Alert Fatigue: Consequences for Patient Outcome

Author:

Carspecken C. William12,Sharek Paul J.34,Longhurst Christopher5,Pageler Natalie M.6

Affiliation:

1. Department of Biomedical Informatics, Stanford University, Stanford, California;

2. Harvard Medical School, Boston, Massachusetts;

3. Center for Quality and Clinical Effectiveness, Lucile Packard Children’s Hospital, Palo Alto, California; and

4. Divisions of General Pediatrics,

5. Systems Medicine, and

6. Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California

Abstract

Despite advances in electronic medication order entry systems, it has been well established that clinicians override many drug allergy alerts generated by the electronic health record. The direct clinical consequences of overalerting clinicians in a pediatric setting have not been well demonstrated in the literature. We observed a patient in the PICU who experienced complications as a result of an extended series of non–evidence-based alerts in the electronic health record. Subsequently, evidence-based allergy alerting changes were made to the hospital’s system. Incorporating clinical evidence in electronic drug allergy alerting systems remains challenging, especially in pediatric settings.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

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