Overriding of Drug Safety Alerts in Computerized Physician Order Entry.

van der Sijs, H., Aarts, J., Vulto, A., & Berg, M. (2006). Overriding of Drug Safety Alerts in Computerized Physician Order Entry. Journal of the American Medical Informatics Association, 13(2), 138-147.

Type

Journal article

Intellectual base

Primary research

Year

2006

Volume

13

Issue

2

Pages

138-147

DOI

10.1197/jamia.m1809

DOI registrant

Oxford University Press

Link

https://doi.org/10.1197/jamia.M1809

Cited from

systems_cybernetics

Cited by

2 citations across 2 artifacts.

Each citation links to the sentence it supports in the citing article.

Primes

• Bypassed Safeguard
  • In medicine, clinicians override low-specificity drug-interaction alerts at very high rates, barcode medication scanning is bypassed when scanners fail, and hand-hygiene compliance falls whenever the dispenser sits off the workflow path.

    This sourceSystematic review documenting that clinicians override drug-safety alerts in 49%–96% of cases, largely driven by low alert specificity.

Domain-specific

• Alarm Fatigue
  • Intensive care units — the most systematically studied habitat: cardiac monitors, ventilators, infusion pumps, and bed sensors fire dozens-to-hundreds of times per patient-day, the majority non-actionable, where the Joint Commission sentinel-event framing originated. Cardiac telemetry / step-down wards — continuous ECG monitoring generates alarm storms during ordinary patient movement, the canonical low-specificity-threshold case. Operating room and anaesthesia workstations — default-conservative thresholds produce a tone wash that anaesthetists learn to filter, with master-caution-style hierarchies borrowed from cockpit alerting as the fix. Post-anaesthesia recovery — high-acuity monitoring with the same base-rate-collapse dynamics as the ICU, receiving ICU-derived alarm-management protocols. EHR drug-interaction alerting — physicians override the large majority of clinically irrelevant interaction prompts

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