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American Journal of Health-System Pharmacy, Vol. 64, Issue 1, 90-96
Copyright © 2007 by American Society of Health-System Pharmacists
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Practice Reports

Effects of technological interventions on the safety of a medication-use system

Kathleen A. Skibinski, Barbara A. White, Lawrence I-Kuei Lin, Yuping Dong and Wenting Wu

KATHLEEN A. SKIBINSKI, M.S., is Clinical Assistant Professor and Associate Dean for Student Affairs, School of Pharmacy, University of Wisconsin, Madison; at the time of this study she was Consultant, American Society of Health-System Pharmacists Research and Education Foundation. BARBARA A. WHITE, M.S., PMP, FASHP, is Consultant, Eclipsys Corporation, Boca Raton, FL; at the time of this study she was Principal Investigator and Project Manager, Missouri Rehabilitation Center, University of Missouri Health Care, Mt. Vernon. LAWRENCE I-KUEI LIN, PH.D., is Research Scientist, Baxter Healthcare Corporation (BHC), Chicago, IL, and Adjunct Professor, Department of Mathematics, Statistics and Computer Science, University of Illinois (UI), Chicago. YUPING DONG, M.S., is a Ph.D. degree candidate, UI, and Statistics Intern, BHC. WENTING WU, PH.D., is Research Associate, Mayo Clinic, Rochester, MN; at the time of this study she was Statistics Intern, BHC.

Address correspondence to Ms. Skibinski at the School of Pharmacy, University of Wisconsin, 777 Highland Avenue, Madison, WI 53705-2222 (kaskibinski{at}pharmacy.wisc.edu).


Purpose. A study was conducted to assess the effects and outcomes of implementing new technology into the medication-use process.

Methods. A pharmacy computer system, automated dispensing cabinets, and point-of-care products were implemented. The hypotheses of the study were that system errors in each phase of the medication-use process would decrease with the implementation of each technological application and that workload measures, such as staffing and inventory levels, would increase. Using a scripted questionnaire, interviews of participating staff (registered nurses, licensed practical nurses, nursing-unit clerks, pharmacists, pharmacy technicians, physicians, and physician assistants) were conducted to determine their impressions of the safety of the medication-use system before and after the implementation of technology. All hospitalwide errors were reported monthly between November 2002 and July 2005 by the number of errors per 1000 patient days and were categorized by error type. The accuracy of the medication administration record was examined; the pharmacy dispensing process was evaluated for accuracy, timeliness, and system changes; the accuracy of medication administration was observed; and staffing changes were also evaluated.

Results. Because of the technology implementation, the accuracy of patient identification was introduced, process changes and technological design identified potential failure modes in the medication administration process, inventory increased, turn-around time to process medication doses in the pharmacy decreased, accuracy of medication administration increased, and the staffing of nurses and pharmacists increased.

Conclusion. Implementation of new technology into the medication management system standardized the medication administration processes, decreased turnaround time for processing medication orders, and increased accuracy of medication administration to patients.

Index terms: Automation; Computers; Dispensing; Drug administration; Drug use; Errors, medication; Identification; Inventory; Manpower; Patients; Pharmacy, institutional, hospital; Quality assurance; Technology; Time studies; Workload

 



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[Abstract] [Full Text] [PDF]


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