Evaluating the relationship between health information technology and safer-prescribing in the long-term care setting: A systematic review

Abstract

BACKGROUND: The prevalence of health information technology (HIT) as an adjunct to increase safety and quality in healthcare applications is well known. There is a relationship between the use of HIT and safer-prescribing practices in long-term care. OBJECTIVE: The objective of this systematic review is to determine an association between the use of HIT and the improvement of prescription administration in long-term care facilities. METHODS: A systematic review was conducted using the MEDLINE and CINAHL databases. With the use of certain key terms, 66 articles were obtained. Each article was then reviewed by two researchers to determine if the study was germane to the research objective. If both reviewers agreed with using the article, it became a source for our review. The review was conducted and structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: The researchers identified 14 articles to include in a group for analysis from North America, Europe, and Australia. Electronic health records and electronic medication administration records were the two most common forms of technological interventions (6 of 14, 43%). Reduced risk, decreased error, decreased missed dosage, improved documentation, improved clinical process, and stronger clinical focus comprised 92% of the observations. CONCLUSIONS: HIT has shown beneficial effects for many healthcare organizations. Long-term care facilities that implemented health information technologies, have shown reductions in adverse drug events caused by medication errors overall reduced risk to the organization. The implementation of new technologies did not increase the time nurses spent on medication rounds.

Interventions to optimize medication use in nursing homes: a narrative review

“…Health information technology (HIT) has the potential to improve medication use in this environment, specifically to reduce the occurrence of medication errors. HIT includes systems such as eMARs, electronic medication management systems, CDSS, electronic health records [ 62 ]. Long-term care facilities have lagged behind other sectors in the adoption of HIT because of the lack of funding [ 62 ].…”

“…HIT includes systems such as eMARs, electronic medication management systems, CDSS, electronic health records [ 62 ]. Long-term care facilities have lagged behind other sectors in the adoption of HIT because of the lack of funding [ 62 ]. The eMAR system was one of the most common types of technology implemented.…”

“…To reduce the risk of MAEs and resulting harms, different approaches have been taken, and the main focus has been the implementation of technological solutions, such as electronic medication administration record (eMAR) and bar-code medication administration [58,[60][61][62]. These technologies might be time-saving, decrease the probability of MAEs such as omitted doses and increase nurse satisfaction [61,62].…”

“…To reduce the risk of MAEs and resulting harms, different approaches have been taken, and the main focus has been the implementation of technological solutions, such as electronic medication administration record (eMAR) and bar-code medication administration [58,[60][61][62]. These technologies might be time-saving, decrease the probability of MAEs such as omitted doses and increase nurse satisfaction [61,62]. However, a SR on eMAR in long-term care facilities reported that eMAR implementation is low, partly because of cost barriers, and there is a lack of rigorously designed research to inform administrators and clinicians about the effect of eMARs and bar-code medication administration on MEs [60].…”

Transformational strategies for optimizing use of medications and related therapies through us pharmacists and pharmacies: Findings from a national study

“… 15 Efforts to reduce medication errors through electronic health records (EHRs), e-prescribing, and other digital technologies show promising results, but are in early stages of development and implementation. 16 Top drugs leading to hospitalizations require regular monitoring, but effective monitoring is not routine in many settings. 17 Many opioid addictions are associated with nonoptimized prescribing and monitoring.…”