Initial Medical Errors After the Implementation of a Clinical Information System in an Intensive Care Unit and Intermediate Medical Care Unit

Abstract

Background: The implementation of clinical information systems (CISs) alone and with hospital electric medical records in intensive care units (ICUs) can lead to numerous errors. This study aimed to investigate errors in an ICU and intermediate medical care unit (IMU) for 9 months after implementing of a CIS. Methods: A CIS was incrementally implemented in the general ICU and IMU of a university hospital over 3 months and was used for all patients by April 2019. The errors encountered over 9 months were extracted from the hospital's incident reporting system. Results: Overall, 122 and 140 errors in the ICU and IMU, respectively, during the study period. Incidence rates of the errors in the ICU and IMU were 31.7 (95% confidence interval [CI] 26.3-37.8) and 51.3 (43.2-60.6) events per 1,000 patient-days, respectively. There were 17 (14%) and 15 (11%) CIS-related errors in the ICU and IMU, respectively. The incidence rates of errors in the ICU and IMU were 5.3 (3.1-8.5) and 6.5 (3.6-10.7) events per 1,000 CIS operation patient-days, respectively. Conclusions: Thirteen percent of the errors in the ICU and IMU were related to the CIS, and the incidence did not vary with the staffing intensity of both care units. The study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN000039402).

Keywords

• clinical information system
• intensive care unit
• electric medical record
• errors