An automated medication system reduces errors in the medication administration process: results from a Danish hospital study

Abstract

ObjectivesImprovements in a hospital's medication administration process might reduce the prevalence of medication errors and improve patient safety. The objective of this study was to evaluate the success of an automated medication system in reducing medication administration errors.MethodsA controlled before-and-after study with follow-up after 4 months was conducted in two Danish haematological hospital wards. The occurrence of administration errors was observed in two 3-week periods. The error rate was calculated by dividing the number of doses with one or more errors by the number of doses (opportunities for errors). Logistic regression was used to assess changes in error rates after implementation of the automated medication system with time, group, and interaction between time and group as independent variables. The estimated parameter for the interaction term was interpreted as the incremental change (‘difference-in-difference’) caused by the new dispensing system.ResultsA total of 697 doses with one or more errors were identified out of 2245 doses. The error rate decreased from 0.35 at baseline to 0.17 at follow-up in the intervention ward and from 0.37 to 0.35 in the control ward. The overall risk of errors was reduced by 57% in the intervention ward compared with the control ward (OR 0.43; 95% CI 0.30 to 0.63).ConclusionsThe automated medication system reduced the error rate of the medication administration process and thus improved patient safety in the medication process.

Self-administration of medication: a pragmatic randomized controlled trial of the impact on dispensing errors, perceptions, and satisfaction

“…Dispensing errors were defined as 'the dispensing of a dose of medication that deviates from the prescription, from hospital guidelines or written procedures' and were divided into clinical and procedural errors as described in the work of Westbrook and colleagues 36 and Risør and colleagues. 12 A clinical error occurred if participants did not receive their medication as prescribed in the eMAR. 12,36 A procedural error occurred if nurses deviated from written procedures or guidelines for the dispensing process.…”

“…Medication errors may increase hospitalization length, healthcare costs, and mortality. [8][9][10] In healthcare settings, medication administration errors, defined as 'the administration of a medication dose that deviates from the prescription, hospital guidelines or written procedures,' 4,11,12 occur in approximately 20% of the total opportunities for error (OEs). 3,4 The medication administration process entails (a) ward-level dispensing of medication into a medicine cup/dosage box and then (b) administering it to patients, based on patient identification.…”

“…3,4 The medication administration process entails (a) ward-level dispensing of medication into a medicine cup/dosage box and then (b) administering it to patients, based on patient identification. 4,12 Some of these errors may be avoided when patients and healthcare professionals work collaboratively through patient involvement. [13][14][15] According to previous research, some patients prefer greater involvement in their treatment and care, 14 which may improve their knowledge, skills, and confidence in managing their condition.…”

Automatic drug distribution systems (unit dose) in hospitals in Poland and in selected countries in the world

“…Implementowanie automatycznych i informatycznych technologii w medycynie i farmacji może zredukować ich liczbę. Nowoczesnymi technologiami pozwalającymi uniknąć błędów medycznych są: system automatycznego dozowania leków, pakowania leków w opakowania multi dose i unit dose [8], wprowadzenie elektronicznych zleceń lekarskich (electronic medication administration recordseMARs) oraz system kodów kreskowych pozwalający identyfikować pojedynczą dawkę leku i pacjenta (barcode-assisted medication administration -BCMA) [6,8]. Aby system indywidualnej dystrybucji leków działał prawidłowo w całym szpitalu, musi składać się z kilku elementów.…”

“…Praca w systemie dystrybucji unit dose satysfakcjonuje zarówno personel apteki szpitalnej, jak i personel zatrudniony na oddziałach szpitalnych [1]. Badanie przeprowadzone w dwóch duńskich uniwersyteckich szpitalach hematologicznych wskazało na redukcję błędów medycznych o 57% w przypadku tabletek, dzięki kontroli elektronicznych zleceń lekarskich przez farmaceutów, systemowi automatycznego dozowania leków i identyfikacji pacjentów za pomocą kodów kreskowych [8]. Natomiast wprowadzenie samego elektronicznego zlecenia lekarskiego spowodowało redukcję błędów medycznych o 55% [33].…”