Fred R. Hargrove

Oral quinolones in hospitalized patients: an evaluation of a computerized decision support intervention*

Objective.  To determine whether a computerized decision support system could increase the proportion of oral quinolone antibiotic orders placed for hospitalized patients.

Implementation of Standardized Concentrations for Continuous Infusions Using a Computerized Provider Order Entry System

Medications given by continuous infusion are a mainstay of therapy in pediatric and neonatal intensive care units. Administering medications by this method allows for titration of doses by simple rate adjustments. Many pediatric hospitals have traditionally used weight-based calculations such as the “rule of six” to determine the concentration to which a medication will be diluted. The “rule of six” calculation involves multiplying the patient’s weight by six to determine the amount of drug in milligrams to be added to 100 mL of diluent. The infusion rate then equals the dose in mcg/kg/min. This formula, while providing an easy method to determine rate adjustments, can lead to medication errors due to the many possible concentrations that are required to meet the needs of patients of varying weights. One of the 2005 National Patient Safety Goals set by the Joint Commission of Accreditation of Healthcare Organizations required institutions to standardize and limit the number of drug concentrations available in order to prevent medication errors. All institutions must implement this standard by 2008. This paper describes the development of standard concentrations at the Monroe Carell Jr. Children’s Hospital at Vanderbilt and the implementation of the standards using our computerized provider order entry system (CPOE).

Using CPOE to Improve Communication, Safety, and Policy Compliance When Ordering Pediatric Chemotherapy:

Medication ordering in the pediatric population is a complex process, which requires the provider to take the patient’s weight, age, and developmental stage into account. Pediatric chemotherapy orders include additional factors such as body surface area (BSA) and the inherent risks of antineoplastic agents, specifically their high potential for toxicity and narrow therapeutic index. At Vanderbilt Children’s Hospital, we use computerized provider order entry (CPOE) for all inpatient chemotherapy orders. This article will describe our use of CPOE to enhance safety, policy compliance, and communication between health care providers when ordering chemotherapy.

Computerized decision support for intravenous fluid management in pediatric patients

This continuing feature describes the clinical pharmacy support tools and services that are provided by the computerized provider order entry (CPOE) system at Vanderbilt University Medical Center (VUMC) — with an emphasis on pediatrics. The authors focus on the development and maintenance of decision support tools created specifically for use in the pediatric population.

Improving communication and safety with CPOE decision support tools

This continuing feature describes the clinical pharmacy support tools and services that are provided by the computerized provider order entry (CPOE) system at Vanderbilt University Medical Center (VUMC) — with an emphasis on pediatrics. The authors focus on the development and maintenance of decision support tools created specifically for use in the pediatric population.

The pharmacist's role in CPOE: A pediatric perspective

This continuing feature describes the clinical pharmacy support tools and services that are provided by the computerized provider order entry (CPOE) system at Vanderbilt University Medical Center (VUMC) — with an emphasis on pediatrics. The authors focus on the development and maintenance of decision support tools created specifically for use in the pediatric population.