Reducing Medication Errorswith the use of Information Technology

Christine M. Buonpastore R.N., BSN Monmouth University, NU 509 Dr. Stark

Impacts of Medication Errors

• Increased morbidity and mortality

• Increased healthcare costs

• Prolonged hospital stays

Types of Medication Errors• Prescription: Wrong medication or wrong dosage

Transcription Error: Illegible physician/care provider handwriting

Dispensing Error: Wrong drug or dosage dispensed from pharmacy Drug dispensed when interacts with a current med

Administration: Wrong drug/dose Wrong patient Patient has allergy

Ways Technology can Help

• Computerized Physician Order Entry prevents transcription errors

Electronic Medication Reconciliation comparing new orders to current meds to prevent interactions, duplications

Automated Dispensing Cabinets monitors controlled substances, maintained by central pharmacy, patient specific drawers

Pharmacy Dispensing Systems

• Implementation of barcodes

• Use of med dispensing robots

• Automated dispensing cabinets/robots

Bar Coded Medication Administration

• Nurse administering medication scans id bracelet AND the unit dose of the medication

• System alerts RN to any discrepancy as to patient name, drug, dose, and route of administration

• Have reported a 58-87% decrease in med errors using such a system

Electronic Medication Reconciliation

• Verifies medications at all points of care: admission, transfer, discharge

• Ensures that all patients meds go with him/her

• Eliminates errors in “forgetting” to prescribe meds at transfer and discharge

Electronic Medical Records(EMRs)

• All patient data kept in one place

• Lifelong patient history can be incorporated

• Allows access to all healthcare providers caring for a specific patient

• Prescriptions, allergies maintained as well

Concerns and Problems

• No evidence of success in small community hospitals

• Resistance to change by medical staff

• Has potential to generate more work for staff, with in-services, mandatory ed,

• System must be designed to optimize clinical workflow

References

Agrawal, A. (2009). Medication errors: Prevention using information technology

systems. Journal of Clinical Pharmacology, 67(6), 681-686. Retrieved April 8, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723209/