Establishment of clinical decision support system for physician order of total nutrient admixture
10.3760/cma.j.cn115822-20210817-00163
- VernacularTitle:全营养混合液医嘱临床决策支持系统的建立
- Author:
Donghui LAO
1
;
Yi JIANG
;
Chun YANG
;
Jianzhong ZHANG
Author Information
1. 复旦大学附属中山医院药剂科，上海200032
- Keywords:
Pharmacy intravenous admixture service;
Pharmacist;
Total nutrient admixture;
Computerized physician order entry system
- From:
Chinese Journal of Clinical Nutrition
2021;29(6):337-342,355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a design of a clinical decision support (CDS) system ithin the computerized physician order entry (CPOE) system to ensure the correct prescribing of total nutrient admixture (TNA) orders.Methods:An improved new workflow was designed in consideration of both the TNA and doctor's prescription work flow. An exclusive CPOE interface for TNA physician order was established, within which a CDS mode was also created. When individual components of the TNA physician order are inputted, automatic calculation is performed through CDS to determine whether patient's clinical nutritional needs and pharmaceutical process requirements are both met. The generated feedback is presented directly to the prescribing clinician in the interface. Through rationality assessment of physician orders and real-time alarm feedback for inappropriate orders, the system can achieve pre-review of TNA orders as well as the education for clinicians on parenteral nutrition order prescription.Results:The usable drug catalog is created at the back end of CDS, thus precluding unreasonable medical orders of therapeutic drugs in TNA regimens. The background CPOE auxiliary support system for parenteral nutrition can correctly evaluate the reasonability of the carrier solution and provide real-time feedback in the CPOE interface.Conclusion:The establishment of the CPOE auxiliary support system eliminates the possibility of unreasonable component proportions and admixture with other therapeutic drugs in TNA orders to ensure TNA orders with rationale component proportion and good compatibility and stability, ultimately satisfying patient's daily calory need and guaranteeing medication safety of parenteral nutrition.
