INTRODUCTION
This project is made as a part of my education as a Master of Information Technology with a focus on Health Informatics at Aalborg University.
The research question is:
Why are there problems with using the CPOE system in an intensive care unit?
This project wishes to discuss why doctors and nurses refuse to use the CPOE system in an intensive care unit, and to understand what impact the CPOE system has on the workflow for nurses and doctors in the medication process. The object is to investigate how nurses and doctors in an intensive care unit perform the medication process with the use of the CPOE system. The focus will be on medication errors and the collaboration between doctors and nurses, and to discuss workflows.
METHODS
The research question has been explored using a literature search to discover the problem area.
The theory used was Müller’s view on technology as a model as described in the book “Samfundets teknologi: Teknologiens samfund” (Müller et al. 1984)
The method used was qualitative interviews as described in Steinar Kvale”s book “Interview” (Kvale 1997) in two intensive care units at two Danish hospitals.
RESULTS
This project identified unintended consequences of using the CPOE system. It has revealed causes of medication errors and inappropriate workarounds, and defined problems within areas concerning technique, knowledge, organization and product. It has also demonstrated that there are striking similarities between findings in literature from abroad, from Denmark and from the results from the interviews.
These errors and workarounds are presented here.
CONCLUSION
After analyzing the interviewees’ responses in relation to Müller’s model of technology, the problems related to the use of the CPOE system have shown to be of various kinds and causing new errors and workarounds. The electronic medication module in hospitals is designed for a rational and linear process, but as nurses and doctors working in a world of volatility and un-predictability, it is very difficult to achieve synergy between these two elements.