Reference no: EM133857384
Assignment:
I need to respond to my peer discussion below.
Discuss your experience with either clinical decision supports and work around and commonalities and differences between your peers' posting and your experience.
Peer discussion
A common EHR workaround I have encountered is prescribers overriding patient allergy alerts. These alerts are intended to protect patients from adverse drug events. Reasons for the overrides include that the allergies may not be correct or that the ones listed do not impact patient care. I have also heard providers say that the allergies listed contain missing and incorrect information. It is estimated that prescribers override over 90% of EHR allergy alerts (Blumenthal et al., 2017). Often technology does not fit well with human factors (McGonigle & Mastrian, 2018). In other words, humans still need to input information in a meaningful way. If information is incorrect, humans may bypass the information in favor of using their best clinical judgement.
I have personally not seen a negative outcome occur because of this practice; however, since the premise for allergy alerts is patient safety, there seems to be more risk than benefit in overriding them. It's a bit like the swiss cheese model of patient safety where it is not if, but when all the holes line up and a patient is harmed. In this case, prescribers do not even view the allergy alerts and prescribe a medication from which the patient has a severe, possibly fatal, allergic reaction.
Since, in my example, staff does not seem to have a clear understanding of how or what to list under allergies, process standardization related to imputing this data seems to be needed. In addition, regular allergy reconciliation, much like what is done with medications, is needed. This would ensure that accurate information is included; thereby promoting patient safety and decreasing EHR alert fatigue (Blumenthal et al., 2017).
LaRee
Blumenthal, K. G., Acker, W. W., Li, Y., Holtzman, N. S., & Zhou, L. (2017). Allergy entry and deletion in the electronic health record. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 118(3), 380-381.
McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.