Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses Page: 29
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(CMS) and the Joint Commission strongly promote technological initiatives intended to improve
patient safety. The Joint Commission, the primary accrediting agency for acute care institutions,
publishes the National Patient Safety Goals (NPSG) with multi-part guidelines for accredited
agencies to implement with prescribed outcome goals. Several suggested initiatives to improve
patient safety are computerized physician order entry (CPOE), automated dosage systems, bar
code technology, and computerized infusion pumps (Moyen et al., 2008, p. 210). These
initiatives involve implementation of new equipment, hardware, software, or major changes in
the work process of health care providers.
The current focus on decreasing errors and improving health care is on the computerized
physician order entry (CPOE) system. "Physician ordering and transcription were responsible for
50 to 61 % of all medication errors" (Bates et al., 1995, Leape et al., 1995, as cited in Shamliyan
et al., 2008). The CPOE system will be a dramatic change in traditional physician ordering and
prescribing practice. Physicians typically have not used computers to write orders; they wrote out
the orders in long-hand, filled in a printed order set, or simply gave orders to the nurse verbally
or by phone. The CPOE system requires physicians to enter orders into a computerized charting
system and do their documentation via the computer. Many CPOE systems have a built-in
decision support system that will activate alerts regarding drug-to-drug interactions, allergy
alerts, and reminders about checking certain other patient parameters regarding the medications
and treatments ordered (Doormaal et al., 2010; Williams & Maddox, 2005). The CPOE system
has been associated with a significant 66% reduction in total prescribing errors, but further
research is needed to evaluate the true impact on medical errors overall (Shamliyan et al., 2008).
CPOE is being strongly promoted because of legislated and monetary incentives provided
for in the economic stimulus bill. According to King (2009) the legislation provides monetary
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Melius, Joyce. Mathematics Anxiety and Mathematics Self-efficacy in Relation to Medication Calculation Performance in Nurses, dissertation, May 2012; Denton, Texas. (digital.library.unt.edu/ark:/67531/metadc115119/m1/37/: accessed July 26, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .