Clinical decision support alerts displayed in EHRs are associated with reduced incidence of medication errors and adverse drug events. However, a physician who inappropriately overrides one of these alerts may hinder their full potential to influence patient safety.
To evaluate this concern, a team of researchers analyzed 712 encounters from patients admitted to one of six intensive care units between July 2016 and April 2017, according to a study published in BMJ Quality & Safety. The researchers considered potential patient harm associated with medication-related CDS overrides for doses, drug allergies, drug interactions, and geriatric and renal alerts.
Here are four insights from the study.
1. The researchers identified 2,448 overridden CDS alerts from 712 patient encounters. Of the 2,448 alerts, 81.6 percent of the alerts were appropriately overridden.
2. The researchers found more potential and definite adverse drug events following inappropriate overrides, compared to appropriate overrides.
3. Inappropriate overrides were six times as likely to be associated with a possible or definite adverse drug event.
4. The study authors concluded, "Further efforts should be targeted at improving the positive predictive value of CDS such as by suppressing alerts that are appropriately overridden."