Evaluation of medication dose omissions amongst inpatients in a hospital using an electronic Medication Management System

Hunt, Katherine V.; Harding, Andrew M; Taylor, Simone E; Curtain, Colin

doi:10.1111/jep.12944

Cited by 10 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Within healthcare settings, omissions are a well-known issue among healthcare staff who have often reported anecdotal evidence of prescribed medicines not reaching patients 12 13. A number of studies have quantified the issue of omissions within hospitals,12 but these either have often been small studies,14–17 focused on one type of medication group,18 or have been conducted in one organisation5 15 19–21 or specific specialty area only 5 16 21 22. The rates of omissions reported by these previous studies have been highly variable, partly due to the varying definitions and classification systems used in studies 15.…”

Section: Introductionmentioning

confidence: 99%

“…The rates of omissions reported by these previous studies have been highly variable, partly due to the varying definitions and classification systems used in studies 15. Furthermore, most of the aforementioned studies have investigated the rate of omissions as the number of doses that have not been administered,18 19 22 23 rather than the number of patients that have not received their medicines. While it is useful to know about the former, it is also useful to know about the latter so that specific patient groups can be prioritised for improvement of omissions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence, nature and risk factors for medication administration omissions in English NHS hospital inpatients: a retrospective multicentre study using Medication Safety Thermometer data

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence, nature and predictors of patients having medication administration omissions in hospitals.MethodsAll medication administration omissions data collected using the standardised methodology of the Medication Safety Thermometer in January 2015 were examined. Hospital inpatients prescribed at least one medication were included in the analysis. Multilevel logistic regression models ascertained the effects of patients’ gender, age, number of prescribed medicines, ward specialty and medicines reconciliation initiation status on the likelihood of having omissions. Valid clinical reasons (VCRs) were excluded from regression models. A sensitivity analysis, excluding patient refusal (PR) omissions, was also conducted.ResultsThe final study sample included 5708 patients from 320 wards in 37 hospitals. Excluding VCRs, 30% of patients had medication administration omissions (95% CI 29 to 30). Approximately half of patients with omissions had refused medicines (51%, 95% CI 49 to 53). Univariable analysis suggested that all variables were significantly associated with omissions. However, in the multivariable model, significant differences were only observed regarding the numbers of medicines patients were prescribed and their ward specialty. Patients prescribed more than 20 medications were approximately five times more likely to have had omissions than patients prescribed one to four medications (OR 4.99, 95% CI 3.22 to 7.73). Patients on surgical wards were also more likely to have had omissions than those on medical wards (OR 1.58, 95% CI 1.14 to 2.18, p=0.006), but there was no significant difference when PRs were excluded (OR 0.5, 95% CI 0.27 to 1.22, p=0.473).ConclusionMedication administration omissions are a substantial problem that affect many hospital patients, and certain patient groups are at higher risk. Specific interventions are required targeting the underlying reasons for medication omissions for different patient subgroups.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence, nature and risk factors for medication administration omissions in English NHS hospital inpatients: a retrospective multicentre study using Medication Safety Thermometer data

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Forcing functions can be included in these systems to maximise the completeness of medical prescriptions, task reminders to administer medications can be included. However, documentation deficiencies may still occur with electronic systems; examples include prescriptions for the wrong patients, medication selection errors and inadequate description of the reasons for missed doses 41…”

Section: Discussionmentioning

confidence: 99%

“…Based on repetitively mentioned and legally required aspects, we identified five core requirements for medication documentation: document authenticity, transparency, clarity, completeness and timeliness(table 1). 7 8 39–41…”

Section: Methodsmentioning

confidence: 99%

Assessing the quality of medication documentation: development and feasibility of the MediDocQ instrument for retrospective chart review in the hospital setting

Hammer

Wagner²,

Manser

2019

BMJ Open

View full text Add to dashboard Cite

ObjectiveThe medication process requires clear and transparent documentation in patient records. Incomplete or incorrect medication documentation may contribute to inappropriate clinical decision-making and adverse events. To comprehensively assess the quality of in-hospital medication documentation, we developed a retrospective chart review (RCR) instrument. We report on the development process, the feasibility of the instrument and describe our application of the instrument to a sample of patient records.DesignCross-sectional study using an RCR instrument to evaluate paper-based, non-standardised prescription and medication administration charts (MediDocQ).SettingTwo German university hospitals.ParticipantsRecords from 1361 patients admitted between April and July 2015 were evaluated.MethodsThe MediDocQ development process comprised six consecutive stages: focused literature review, web-based search, initial patient record screening, review by project advisory board, focus groups with professionals and pilot testing. The final 54-item RCR instrument covers three key components of medication documentation: (1) completeness of documented information (including prescription, medication administration and pro re nata (PRN) medication), (2) quality of transcriptions and (3) compliance with chart structure, legibility, handling of deletions and chart corrections. Descriptive statistics are presented as mean values, SD, median and interquartile ranges for individual items.ResultsOverall, 33 out of 54 items resulted in mean values above 0.75, indicating high-quality medication documentation. Documentation quality was particularly compromised for verbal and PRN orders (which involve more steps than standard orders) and when documentation was not completed at the same time as medication administration.ConclusionsMediDocQ is a patient safety instrument that can be used to evaluate the quality of medication documentation and identify components of the process where intervention is required. In our setting, standardisation of medication documentation, particularly regarding medication administration and PRN medication is a priority.

show abstract

“…Penyebab umum kesalahan pengobatan terkait peresepan meliputi kemiripan obat (Look alike sound alike), tulisan tangan tidak terbaca, kesalahan transkripsi, singkatan yang tidak tepat, dan perhitungan dosis yang tidak akurat. Dibandingkan dengan catatan medis kertas, EMMS telah terbukti mengurangi prevalensi jenis medication error (Hunt, Harding, Taylor, & Curtain, 2018).…”

Section: Rumahunclassified

Penggunaan Electronic Medication Management (EMM) dalam Menurunkan Kejadian Medication Error di Keperawatan

Indriani

2020

View full text Add to dashboard Cite

Errors in drug administration are adverse events for patients. Reducing the incidence of medication errors will significantly improve patient safety and quality of medication use. The traditional system makes staff spend time searching through notes on a compilation paper of what drugs patients must pay throughout the treatment process that is given. This process is not only lengthy, but also can easily increase opportunities for differences and mistakes. Many hospitals and health services are turning to digital systems as a solution. The EMM system supports the improvement of quality, safety, and support for drug management in hospitals. This includes providing support for doctors, nurses and pharmacists to prescribe, order, accept, reconcile, issue and install digital drug administration. EMM covers the entire treatment cycle in the hospital including prescribing by doctors, approved and issued drug orders by pharmacists, and administration of drugs by nurses. The use of EMM can provide benefits that are improving the quality of patient-oriented nursing care, the quality of clinical services and the use of information technology. Nurses as health workers with the largest

show abstract

Evaluation of medication dose omissions amongst inpatients in a hospital using an electronic Medication Management System

Cited by 10 publications

References 18 publications

Prevalence, nature and risk factors for medication administration omissions in English NHS hospital inpatients: a retrospective multicentre study using Medication Safety Thermometer data

Prevalence, nature and risk factors for medication administration omissions in English NHS hospital inpatients: a retrospective multicentre study using Medication Safety Thermometer data

Assessing the quality of medication documentation: development and feasibility of the MediDocQ instrument for retrospective chart review in the hospital setting

Penggunaan Electronic Medication Management (EMM) dalam Menurunkan Kejadian Medication Error di Keperawatan

Contact Info

Product

Resources

About