scholarly journals An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 148
Author(s):  
Sara Barakat ◽  
Bryony Dean Franklin
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Medication Administration ◽  
Patient Identification ◽  
Identification Rate ◽  
Scan Rate ◽  
Nursing Activity ◽  
Administration Time ◽  
Potential Benefits ◽  
The Impact

Barcode medication administration (BCMA) is advocated as a technology that reduces medication errors relating to incorrect patient identity, drug or dose. Little is known, however, about the impact it has on nursing workflow. Our aim was to investigate the impact of BCMA on nursing activity and workflow. A comparative study was conducted on two similar surgical wards within an acute UK hospital. We observed nurses during drug rounds on a non-BCMA ward and a BCMA ward. Data were collected on drug round duration, timeliness of medication administration, patient identification, medication verification and general workflow patterns. BCMA appears not to alter drug round duration, although it may reduce the administration time per dose. Workflow was more streamlined, with less use of the medicines room. The rate of patient identification increased from 74% (of 47) patients to 100% (of 43), with 95% of 255 scannable medication doses verified using the system. This study suggests that BCMA does not affect drug round duration; further research is required to determine the impact it has on timeliness of medication administration. There was reduced variability in the medication administration workflow of nurses, along with an increased patient identification rate and high medication scan rate, representing potential benefits to patient safety.

scholarly journals THE IMPACT OF BARCODE MEDICATION ADMINISTRATION ON PATIENT SAFETY: A SYSTEMATIC REVIEW

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Seham Sahal Aloufi
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Medication Error ◽  
Medication Errors ◽  
Improve Patient Safety ◽  
Hospital Setting ◽  
Medication Administration ◽  
Bar Code ◽  
The Impact ◽  
Improve Patient

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety. Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure. This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies. The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration. Keyword: Patient Safety, Impact, BCMA, eMAR

scholarly journals Medication Administration Errors and Contributing Factors at Nurses Workplace: Literature Review

2021 ◽  
Vol 2 (10 (298)) ◽  
pp. 1-10
Author(s):  
Dovilė Sakalauskaitė ◽  
Viktorija Kielė
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Work Environment ◽  
Medication Errors ◽  
Human Factor ◽  
Medication Administration ◽  
Medical Team ◽  
Contributing Factors ◽  
Medication Administration Errors ◽  
Administration Time

Abstract. Medication errors are a serious problem that can be a threat to health and patient safety and can lead to mistrust of the health system and the work of professionals. Medication administration errors occur at any stage of patient care and can be related to a variety of influencing factors [1]. This literature review identifies the main medication administration errors, which are grouped into medication administration and incorrect documentation of administered medication groups. Along with medication administration errors, the main reasons why nurses make errors in medication administration are identified. The study focuses on medication administration errors and their determinants in nurses' work. The aim of the literature review was to analyze medication errors and their determinants in nurses' work. Methods: an exploratory review was conducted to analyze medication administration errors and their determinants in nurses' work. The methodology considered five main stages that contributed to a focused analysis of the selected studies. Results of the literature review. It was found that medication errors are influenced by the work environment, which is full of extraneous sounds, other members of the medical team, and conversations unrelated to the administration of medicines. The human factor is also a factor in medication administration errors related to the medication, its dose, or the wrong administration time. Medication administration errors are inevitable, no matter how advanced the patient's care and nursing techniques.

scholarly journals Preliminary Review of the Effects of Electronic Medical Administration Records (eMAR) and Electronic Doctor Order Entry (CPOE) on Patient Safety Culture in the Era of Universal Health Services

SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 243
Author(s):  
Rahmat Santoso ◽  
Stefanus Nova
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Medication Administration ◽  
Health Care Facilities ◽  
Preliminary Review ◽  
Future Research ◽  
Order Entry ◽  
Pharmaceutical Service ◽  
The Impact ◽  
Universal Health

In the era of universal health service [UHC], medicine was always used as part of curative, preventive, and promotive. Following pharmaceutical service standards in hospitals, health centers, and pharmacies, that medicines must be managed properly, including in their use. Medication errors are a leading cause of death in many parts of the world. The factors causing the increase in medication errors related to individuals, such as heavy workload on health care facilities and pharmaceutical service facilities, are often experienced by medical staff (General Practitioners and Specialists) and pharmaceutical personnel (Pharmacists and Pharmaceutical Technical Personnel / TTK), or organizational-related factors, such as inadequate facilities and infrastructure to document medication administration records and the entry of physician orders electronically. The study was conducted cross-sectionally retrospectively, by sharing the results of an initial literature review on the impact of electronic medication administration records (eMAR) and doctor's order entry (CPOE) on patient safety. Using PubMed and Google Scholar, we search for the following terms: "eMAR", "CPOE", "medication error", and "patient safety". Our initial findings reveal that eMAR and CPOE can have an impact on the pharmaceutical workflow, and reduce medication errors, thereby increasing patient safety. Based on the initial review, eMAR and CPOE influence the insight of pharmaceutical personnel, pharmaceutical workflows and impact on patient safety. On the other hand, there is a regulatory direction which is still in the form of a Regulation of the Minister of Health Regulation on Providers of Electronic Pharmaceutical Facilities (PSEF), but it is unfortunate that "eMAR" and "CPOE" have not become clauses governed by the government. Our plan for future research is to conduct a systematic review study to further study the impact of eMAR and CPOE on patient safety.

Progressive Care Nurses Improving Patient Safety by Limiting Interruptions During Medication Administration

2016 ◽  
Vol 36 (4) ◽  
pp. 19-35 ◽  
Author(s):  
Fran Flynn ◽  
Julie Q. Evanish ◽  
Josephine M. Fernald ◽  
Dawn E. Hutchinson ◽  
Cheryl Lefaiver
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Comparison Group ◽  
Medication Administration ◽  
Cardiac Care ◽  
Evidence Based ◽  
Direct Observations ◽  
Medication Administration Errors ◽  
Before And After ◽  
The Impact

Background Because of the high frequency of interruptions during medication administration, the effectiveness of strategies to limit interruptions during medication administration has been evaluated in numerous quality improvement initiatives in an effort to reduce medication administration errors. Objectives To evaluate the effectiveness of evidence-based strategies to limit interruptions during scheduled, peak medication administration times in 3 progressive cardiac care units (PCCUs). A secondary aim of the project was to evaluate the impact of limiting interruptions on medication errors. Methods The percentages of interruptions and medication errors before and after implementation of evidence-based strategies to limit interruptions were measured by using direct observations of nurses on 2 PCCUs. Nurses in a third PCCU served as a comparison group. Results Interruptions (P < .001) and medication errors (P = .02) decreased significantly in 1 PCCU after implementation of evidence-based strategies to limit interruptions. Avoidable interruptions decreased 83% in PCCU1 and 53% in PCCU2 after implementation of the evidence-based strategies. Conclusions Implementation of evidence-based strategies to limit interruptions in PCCUs decreases avoidable interruptions and promotes patient safety.

Analisis Faktor Perawat Dalam Pelaksanakan Keselamatan Pasien Terhadap Kejadian Medication Administration Error di Rumah Sakit

2020 ◽  
Author(s):  
Bintang Marsondang Rambe
Keyword(s):  
Patient Safety ◽  
Literature Review ◽  
Medication Error ◽  
Medication Errors ◽  
Medication Administration ◽  
Prescribing Error ◽  
Medication Administration Error ◽  
Administration Error

Latar Belakang Keselamatan pasien (patient safety) rumah sakit adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman yang meliputi assessment risiko, identifikasi dan pengelolaan hal yang berhubungan dengan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya serta implementasi solusi untuk meminimalkan timbulnya risiko dan mencegah terjadinya cedera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil yang dilakukan oleh perawat (Kemenkes, 2011).Salah satu kesalahan yang dapat merugikan pasien adalah medication error. Menurut WHO (2016) medication error adalah setiap kejadian yang dapat dicegah yang menyebabkan penggunaan obat yang tidak tepat yang menyebabkan bahaya kepasien, dimana obat berada dalam kendali profesional perawatan kesehatan. proses terjadi medication error dimulai dari tahap prescribing, transcribing, dispensing,dan administration. Kesalahan peresepan (prescribing error), kesalahan penerjemahan resep (transcribing erorr), kesalahan menyiapkan dan meracik obat (dispensing erorr), dan kesalahan penyerahan obat kepada pasien (administration error). Medication error yang paling sering terjadi adalah pada fase administration / pemberian obat yang dilakukan oleh perawat.Administration error terjadi ketika pemberian obat kepada pasien tidak sesuai dengan prinsip enam benar yaitu benar obat, benar pasien, benar dosis, benar rute pemberian, benar waktu pemberian dan benar pendokumentasian. Secara global, kesalahan pemberian obat (medication errors) sampai saat ini masih menjadi isu keselamatan pasien dan kualitas pelayanan di beberapa rumah sakit (Depkes RI, 2015; AHRQ, 2015). Perawat sebagai bagian terbesar dari tenaga kesehatan di rumah sakit, mempunyai peranan dalam kejadian medication error. Perawat berkontribusi karena perawat banyak berperan dalam proses pemberian obat. Pemberian obat/ Medication Administration adalah salah satu intervensi keperawatan yang paling banyak dilakukan, dengan sekitar 5- 20% waktu perawat dialokasikan untuk kegiatan ini (Härkänen et al.,, 2019). Pemberian obat juga mencakup tugas-tugas lain, seperti menyiapkan dan memeriksa obat obatan, memantau efek obat-obatan, mengedukasi pasien tentang pengobatan, dan memperdalam pengetahuan perawat tentang obat – obatan sendiri (DrachZahavy et al., 2014 dalam Yulianti et al., 2019)Berdasarkan isu tersebut, penulis tertarik untuk melakukan literature review terkait faktor perawat dalam pelaksanakan keselamatan pasien terhadap kejadian medication administration error di Rumah Sakit.

scholarly journals The Impact of a Location-Sensing Electronic Health Record on Clinician Efficiency and Accuracy: A Pilot Simulation Study

2018 ◽  
Vol 09 (04) ◽  
pp. 841-848
Author(s):  
Kevin King ◽  
John Quarles ◽  
Vaishnavi Ravi ◽  
Tanvir Chowdhury ◽  
Donia Friday ◽  
...  
Keyword(s):  
Patient Safety ◽  
Pilot Study ◽  
Human Computer Interaction ◽  
Real Time ◽  
Identification Accuracy ◽  
Patient Identification ◽  
Location Services ◽  
Electronic Health ◽  
The Impact ◽  
Computer Interaction

Background Through the Health Information Technology for Economic and Clinical Health Act of 2009, the federal government invested $26 billion in electronic health records (EHRs) to improve physician performance and patient safety; however, these systems have not met expectations. One of the cited issues with EHRs is the human–computer interaction, as exhibited by the excessive number of interactions with the interface, which reduces clinician efficiency. In contrast, real-time location systems (RTLS)—technologies that can track the location of people and objects—have been shown to increase clinician efficiency. RTLS can improve patient flow in part through the optimization of patient verification activities. However, the data collected by RTLS have not been effectively applied to optimize interaction with EHR systems. Objectives We conducted a pilot study with the intention of improving the human–computer interaction of EHR systems by incorporating a RTLS. The aim of this study is to determine the impact of RTLS on process metrics (i.e., provider time, number of rooms searched to find a patient, and the number of interactions with the computer interface), and the outcome metric of patient identification accuracy Methods A pilot study was conducted in a simulated emergency department using a locally developed camera-based RTLS-equipped EHR that detected the proximity of subjects to simulated patients and displayed patient information when subjects entered the exam rooms. Ten volunteers participated in 10 patient encounters with the RTLS activated (RTLS-A) and then deactivated (RTLS-D). Each volunteer was monitored and actions recorded by trained observers. We sought a 50% improvement in time to locate patients, number of rooms searched to locate patients, and the number of mouse clicks necessary to perform those tasks. Results The time required to locate patients (RTLS-A = 11.9 ± 2.0 seconds vs. RTLS-D = 36.0 ± 5.7 seconds, p < 0.001), rooms searched to find patient (RTLS-A = 1.0 ± 1.06 vs. RTLS-D = 3.8 ± 0.5, p < 0.001), and number of clicks to access patient data (RTLS-A = 1.0 ± 0.06 vs. RTLS-D = 4.1 ± 0.13, p < 0.001) were significantly reduced with RTLS-A relative to RTLS-D. There was no significant difference between RTLS-A and RTLS-D for patient identification accuracy. Conclusion This pilot demonstrated in simulation that an EHR equipped with real-time location services improved performance in locating patients and reduced error compared with an EHR without RTLS. Furthermore, RTLS decreased the number of mouse clicks required to access information. This study suggests EHRs equipped with real-time location services that automates patient location and other repetitive tasks may improve physician efficiency, and ultimately, patient safety.

scholarly journals Reducing errors in the administration of medication with infusion pumps in the intensive care department: A lean approach

2019 ◽  
Vol 7 ◽  
pp. 205031211882262
Author(s):  
Alexander F van der Sluijs ◽  
Eline R van Slobbe-Bijlsma ◽  
Astrid Goossens ◽  
Alexander PJ Vlaar ◽  
Dave A Dongelmans
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Confidence Interval ◽  
Medication Errors ◽  
Infusion Pump ◽  
Baseline Measurement ◽  
Infusion Pumps ◽  
Improvement Measures ◽  
The Impact

Background: Medication errors occur frequently and may potentially harm patients. Administering medication with infusion pumps carries specific risks, which lead to incidents that affect patient safety. Objective: Since previous attempts to reduce medication errors with infusion pumps failed in our intensive care unit, we chose the Lean approach to accomplish a 50% reduction of administration errors in 6 months. Besides improving quality of care and patient safety, we wanted to determine the effectiveness of Lean in healthcare. Methods: We conducted a before-and-after observational study. After baseline measurement, a value stream map (a detailed process description, used in Lean) was made to identify important underlying causes of medication errors. These causes were discussed with intensive care unit staff during frequent stand-up sessions, resulting in small improvement cycles and bottom-up defined improvement measures. Pre-intervention and post-intervention measurements were performed to determine the impact of the improvement measures. Infusion pump syringes and related administration errors were measured during unannounced sequential audits. Results: Including the baseline measurement, 1748 syringes were examined. The percentage of errors concerning the administration of medication by infusion pumps decreased from 17.7% (95% confidence interval, 13.7–22.4; 55 errors in 310 syringes) to 2.3% (95% confidence interval, 1–4.6; 7 errors in 307 syringes) in 18 months (p < 0.0001). Conclusion and Relevance: The Lean approach proved to be helpful in reducing errors in the administration of medication with infusion pumps in a high complex intensive care environment.

Keselamatan Pemberian Medikasi

2010 ◽  
Vol 13 (2) ◽  
pp. 105-111
Author(s):  
Agustin Indracahyani
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Medication Errors ◽  
Health Care Services ◽  
Medication Management ◽  
Medication Administration ◽  
Process Approach ◽  
Nursing Process ◽  
Care Services ◽  
The World

AbstrakKesalahan medikasi merupakan masalah yang sangat serius di pelayanan kesehatan di seluruh dunia. Masalah tersebut mengakibatkan cedera dan kematian bagi pasien, serta meningkatkan biaya yang harus dikeluarkan oleh rumah sakit. Kesalahan medikasi dapat terjadi di setiap tahapan proses manajemen dan penggunaan medikasi dan berakibat pada keselamatan pasien. Kesalahan medikasi dapat terjadi akibat kondisi laten, kondisi yang menyebabkan kesalahan, dan kegagalan aktif. Perawat sebagai pihak yang paling banyak terlibat dalam proses pemberian medikasi memiliki peran penting dalam mencegah, mengenali, dan mengatasi terjadinya kesalahan untuk meningkatkan keselamatan pemberian medikasi. Upaya meningkatkan keselamatan pemberian medikasi dilakukan melalui pendekatan proses keperawatan sejak pengkajian hingga evaluasi dan dokumentasi. AbstractMedication errors are a very serious problem in health care services around the world. These problems lead to morbidity and mortality for patients, as well as increase the costs to be incurred by the hospital. Medication errors may occur at any stages of medication management and use process and result in patient safety. These may occur due to latent conditions, error producing conditions, and active failures. Nurses who are primarily involved in the process of medication administration have important role in preventing, recognizing, and addressing errors in order to enhance safety medication administration. Efforts to enhance safety medication administration may be done through nursing process approach from assessment to evaluation and documentation.

scholarly journals Does electronic medication reconciliation at hospital discharge decrease prescription medication errors?

2015 ◽  
Vol 28 (6) ◽  
pp. 564-573 ◽  
Author(s):  
Geneve M. Allison ◽  
Bernard Weigel ◽  
Christina Holcroft
Keyword(s):  
Patient Safety ◽  
Hospital Discharge ◽  
Medication Errors ◽  
Medication Reconciliation ◽  
Improve Patient Safety ◽  
Safety Issue ◽  
Inpatient Service ◽  
Intravenous Antibiotic ◽  
Content Type ◽  
The Impact

Purpose – Medication errors are an important patient safety issue. Electronic medication reconciliation is a system designed to correct medication discrepancies at transitions in healthcare. The purpose of this paper is to measure types and prevalence of intravenous antibiotic errors at hospital discharge before and after the addition of an electronic discharge medication reconciliation tool (EDMRT). Design/methodology/approach – A retrospective study was conducted at a tertiary hospital where house officers order discharge medications. In total, 100 pre-EDMRT and 100 post-EDMRT subjects were randomly recruited from the study center’s clinical Outpatient Parenteral Antimicrobial Therapy (OPAT) program. Using infectious disease consultant recommendations as gold standard, each antibiotic listed in these consultant notes was compared to the hospital discharge orders to ascertain the primary outcome: presence of an intravenous antibiotic error in the discharge orders. The primary covariate of interest was pre- vs post-EDMRT group. After generating the crude prevalence of antibiotic errors, logistic regression accounted for potential confounding: discharge day (weekend vs weekday), average years of practice by prescribing physician, inpatient service (medicine vs surgery) and number of discharge mediations per patient. Findings – Prevalence of medication errors decreased from 30 percent (30/100) among pre-EDMRT subjects to 15 percent (15/100) errors among post-EDMRT subjects. Dosage errors were the most common type of medication error. The adjusted odds ratio of discharge with intravenous antibiotic error in the post-EDMRT era was 0.39 (0.18, 0.87) compared to the pre-EDMRT era. In the adjusted model, the total number of discharge medications was associated with increased OR of discharge error. Originality/value – To the authors’ knowledge, no other study has examined the impact of reconciliation on types and prevalence of medication errors at hospital discharge. The focus on intravenous antibiotics as a class of high-stakes medications with serious risks to patient safety during error events highlights the clinical importance of the findings. Electronic medication reconciliation may be an important tool in efforts to improve patient safety.

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