Impact of an electronic medication administration record on medication administration efficiency and errors.
The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.
Author Affiliations: Scripps Memorial Hospital, La Jolla (Mr McComas); and School of Nursing, Point Loma Nazarene University, San Diego (Dr Riingen), CA; and St David's School of Nursing, Texas State University, Round Rock (Dr Kim). This study was performed as part of the MSN degree requirements at School of Nursing, Point Loma Nazarene University, San Diego, CA.
Jeffery
J
McComas
Michelle
M
Riingen
Son
S
Chae Kim
D017598:Efficiency, Organizational; D006801:Humans; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000451:nursing / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D009741:Nursing Staff, Hospital; D011446:Prospective Studies; D013996:Time and Motion Studies