Evaluation of harm associated with high dose-range clinical decision support overrides in the intensive care unit.

Wong A, Rehr C, Seger DL, et al. Drug Saf. 2018 Dec 1; [Epub ahead of print].

Although clinical decision support is intended to improve safety, decision support alerts often result in alert fatigue and overrides. This prospective observational study examined overrides for exceeding the maximum dose of a medication in the intensive care unit. Researchers determined that insulin was the most frequent medication for which a maximum dosage alert was overridden. In almost 90% of cases, the overrides were deemed clinically appropriate. The authors conclude that more intelligent clinical decision support for medication dosing is needed to balance safety with alert fatigue in the intensive care unit. A past PSNet perspectivediscussed the challenges of implementing effective medication decision support systems.

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