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The impact of a hospital electronic prescribing and medication administration system on medication administration safety: an observational study
- Source :
- BMC Health Services Research, Vol 17, Iss 1, Pp 1-10 (2017), BMC Health Services Research
- Publication Year :
- 2017
- Publisher :
- BMC, 2017.
-
Abstract
- Background The aim of the study was to explore the impact of the implementation of an electronic prescribing and medication administration system (ePA) on the safety of medication administration in an inpatient hospital setting. Objectives were to compare the prevalence and types of: 1) medication administration errors, and 2) documentation discrepancies, between a paper and an ePA system. Additionally, we wanted to describe any observed changes to medication administration practices. Methods The study was based on an elderly medicine ward in an English hospital. From December 2014 to June 2015, nurses’ medication administration rounds were observed every 5 days before and after ePA implementation using an interrupted time-series approach. Medication administration error and documentation discrepancy rates pre- versus post-ePA were analysed descriptively and chi-squared tests used to test for any difference; segmented regression analysis was used to determine changes in longitudinal trend. Results Observations were made at 15 pre- and 15 post-ePA implementation time-points. Pre-ePA on paper, there were 18 medication administration errors in 428 opportunities for error (4.2%; 95% confidence interval 2.3–6.1%), and with ePA there were 18 in 528 (3.4%; 95% confidence interval 1.9–5.0%; p = 0.64). Regarding documentation, pre-ePA on paper there were 5 discrepancies in 460 observed documentations (1.1%; 95% confidence interval 0.1–2.0%); with ePA there were 18 in 557 (3.2%; 95% confidence interval 1.8–4.7%; p = 0.04). The most common electronic documentation discrepancy was documentation that a dose had been administered when it had not. Segmented regression analysis was unable to detect any significant longitudinal changes. Changes to working practices post-ePA were observed, such as nurses demonstrating less-consistent self-checking when preparing and administering medications. Conclusions Findings suggest no change in medication error rate, although ePA encourages certain types of errors and mitigates others. There was a statistically significant increase in documentation discrepancies which is likely to be due to adoption of new working practices with ePA. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2462-2) contains supplementary material, which is available to authorized users.
- Subjects :
- Pediatrics
medicine.medical_specialty
Medication Systems, Hospital
Documentation
ERRORS
Health informatics
Health administration
03 medical and health sciences
Hospital
0807 Library And Information Studies
0302 clinical medicine
PROVIDER ORDER ENTRY
Electronic prescribing
Observational study
Medication errors
London
Patients' Rooms
medicine
QUALITY
Humans
030212 general & internal medicine
Hospitals, Teaching
Aged
Science & Technology
business.industry
030503 health policy & services
Health Policy
Nursing research
Public health
lcsh:Public aspects of medicine
Interrupted Time Series Analysis
lcsh:RA1-1270
Confidence interval
Health Care Sciences & Services
1117 Public Health And Health Services
Emergency medicine
Health Policy & Services
0305 other medical science
business
Life Sciences & Biomedicine
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....89e95b3a33fc7394d5e1b5ed94e9c6c6