Background Although several types of computerized provider order entry (CPOE)-related errors may occur, errors related to inconsistent information within the same prescription (ie, mismatch between the structured template and the associated free-text field) have not been described, to our knowledge. We determined the nature and frequency of such errors and identified their potential predictive variables. Methods In this prospective study, we enrolled pharmacists to report prescriptions containing inconsistent communication over a 4-month period at a tertiary care facility. We also electronically retrieved all prescriptions written during the study period containing any comments in the free-text field and then randomly selected 500 for manual review to determine inconsistencies between free-text and structured fields. Of these, prescriptions without inconsistencies were categorized as controls. Data on potentially predictive variables from reported and unreported errors and controls were collected. For all inconsistencies, we determined their nature (eg, drug dosage or administration schedule) and potential harm and used multivariate logistic regression models to identify factors associated with errors and harm. Results Of 55 992 new prescriptions, 532 (0.95%) were reported to contain inconsistent communication, a rate comparable to that obtained from the unreported group. Drug dosage was the most common inconsistent element among both groups. Certain medications were more likely associated with errors, as was the inpatient setting (odds ratio, 3.30; 95% confidence interval, 2.18–5.00) and surgical subspecialty (odds ratio, 2.45; 95% confidence interval, 1.57–3.82). About 20% of errors could have resulted in moderate to severe harm, for which significant independent predictors were found. Conclusions Despite standardization of data entry, inconsistent communication in CPOE poses a significant risk to safety. Improving the usability of the CPOE interface and integrating it with workflow may reduce this risk.
The first observations of reproduction and associated behaviors in captive bigfin eelpout, Lycodes cortezianus, and pallid eelpout, Lycodapus mandibularis, are reported here. One Lycodes cortezianus pair produced 13 transparent and negatively buoyant eggs that were approximately 6 mm in diameter. These were laid on a hydroid-covered rock. The development period was about 7 months, and the young that emerged were approximately 2 cm in total length. An additional captive pair also exhibited mating behavior as the male repeatedly nudged the female and the pair produced a burrow under a sponge; however the male died before any mating. Two gravid female Lycodapus mandibularis were captured and laid between 23 and 46 eggs that were about 4 mm in diameter. These were released on the sandy substrate after the females moved the sand about the tank, and the eggs were negatively buoyant. These eggs were all unfertilized. Additional burrowing behavior was observed from other captive individuals, but no eggs were subsequently produced. Taken together, our observations suggest that burrowing or use of other protective structures is a reproductive behavior of central importance to zoarcids. Contrary to some earlier hypotheses, even midwater species likely return to the sediment to burrow and/or deposit eggs. This behavior means that field data regarding reproduction in this family will continue to be difficult to obtain, and the contribution of further study in laboratory situations should not be underestimated.
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