Introduction: Medication administration error (MAE) is the improper dispensing of medication. It is a significant contributor to the occurrence of medical errors. A novel systems thinking approach using a pediatric simulation and student nurses were used to evaluate the benefit of applying just-in-time information (JITI) to reduce medication errors. Just-intime information applies highly focused information delivered when needed. Methods: A smart device app was developed to provide JITI medication administration information. The effect JITI had on MAE occurrence was assessed via a controlled study. The study population included 38 teams having 2 to 3 senior nursing students on each team. The teams were separated into a control and 2 intervention groups to complete a medication administration simulation. Results: The intervention groups (100%, N = 10) that made significant use of the JITI app demonstrated improved performance for medication administration over the control group. Familiarity with the app was pivotal to how frequently it was used and to the success of the groups in administering medications. Although those with access to the app having limited training successfully executed the simulation 27.3% (n = 11) of the time, those with extended training had a success rate of 77.8% (n = 9). Conclusions: Providing JITI significantly reduced the occurrence of MAEs for these student nurses. Familiarity with the app, including extended training opportunities, contributed significantly to student success.
It has been 20 years since the National Academy of Medicine released its report, “To Err Is Human,” which shocked the healthcare community on the pervasiveness of medical error. While errors in medication administration are a significant contributor to medical error, research seeking to understand the complex systems nature and occurrence of medication administration error is limited. Computer modeling is increasingly being used in the healthcare industry to assess the impact of changes made to healthcare processes. The objective of the study is to evaluate the use of agent-based modeling, a type of computer modeling that allows the simulation of virtual individuals and their behavior, to simulate nurse performance in the medication administration process. The model explores the effect of Just-in-Time information, as an intervention, on the occurrence of medication error. The model demonstrated significant utility in understanding the interplay of the system elements of the nurse medication administration process. Therefore this approach, using systems-level computer simulation such as agent-based models, can help administrators understand the effects of changes to the medication administration process as they work to reduce errors and increase performance.
Old myths and new realities: A 21st century space reactor cost estimate AIP Conf.Abstract. Investment in developing nuclear power for space missions cannot be made on the basis of a single mission. Current efforts in the design and fabrication of the reactor module, including the reactor shield, must be cost-effective and take into account scalability and fabricability for planned and future missions. Engineering considerations for the shield need to accommodate passive thermal management, varying radiation levels and effects, and structural/mechanical issues. Considering these challenges, design principles and cost drivers specific to the engineering and fabrication of the reactor shield are presented that contribute to lower recurring mission costs. Shield Design and Functional ConsiderationsThe radiation shield is complex in terms of its thermal management, materials of construction, and functional requirements (structural and radiation attenuation). As with many other parts of the spacecraft, the shield has a This article is copyrighted as indicated in the article. Reuse of AIP content is subject to the terms at: http://scitation.aip.org/termsconditions. Downloaded to IP: 131.215.225.9 On
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