The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review

Zheng, Wu; Lichtner, Valentina; Dort, Bethany A Van; Baysari, Melissa T.

doi:10.1016/j.sapharm.2020.08.001

Cited by 39 publications

(28 citation statements)

References 40 publications

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“…The most common subtype being the incorrect form/dose of drug dispensed. Hospitals can cut down significantly on dispensing errors by using automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems as demonstrated by a systematic review by Zheng et al [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Medication Errors in a Tertiary Care Hospital of a Low- to Middle-Income Country

Parthasarathi¹,

Puvvada²,

Patel

et al. 2021

Cureus

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Introduction Medication errors (MEs) are a major public health concern as they are detrimental to patient safety, compromise patients' confidence in the healthcare system, increase healthcare costs, and adversely affect the patient's quality of life. This is especially true in low to middle-income countries where the significance of MEs is largely undervalued. This study aims to investigate the prevalence of MEs and analyze the causes, medicines involved, reporting, and severity of MEs in a tertiary care setting. Methods A prospective observational study was conducted from March 2020 to February 2021 in a tertiary care teaching hospital in South India. The data was collected after reviewing patient medical records, by interviewing patients and healthcare professionals. National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index was used to evaluate MEs. Results A total of 557 MEs were identified from 3798 patients with a prevalence of 14.6%. Prescribing errors were the most commonly observed ME followed by errors related to documentation of medical records, administration-related errors, and dispensing errors. Lack of time for documentation of medication records, shift change and work overload were common causes of MEs. The majority of MEs were category A and B of the NCC MERP severity index. Conclusion Antibiotics and proton pump inhibitors were the most common medicines involved in MEs. Prescribing and documentation errors were most prevalent. Implementation of systems like strict adherence to treatment guidelines, computerized provider order entry (CPOE), barcode medication administration, and closed-loop electronic medication management systems may greatly help reduce MEs. All healthcare institutions should undertake routine audits to determine the prevalence and causes of medication errors.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Medication Errors in a Tertiary Care Hospital of a Low- to Middle-Income Country

Parthasarathi¹,

Puvvada²,

Patel

et al. 2021

Cureus

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“…28 Nevertheless, it may not be feasible for small or community hospitals to implement such interventions due to high initial costs and problems with automated carts. 35 Reorganization of the workplace/anesthesia cart into a standardized fashion is more practical and allows for a more robust routine in these fast-paced environments, and labels with large, bold fonts with colour-labelling can reduce visibility issues that may contribute to errors. Furthermore, standardization, as part of these changes, can help reduce the cognitive load/burden of anesthesiologists.…”

Section: Impact Of Interventionsmentioning

confidence: 99%

Interventions to reduce medication errors in anesthesia: a systematic review

Maximous

Wong

Chung

et al. 2021

Can J Anesth/J Can Anesth

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Background The objective of this study was to provide a synthesis of the interventions designed to reduce medication errors in anesthetized patients. Methods We electronically searched major databases using index and free-text keywords related to anesthesia and medication errors. We included cohort studies exploring interventions to reduce anesthetic medication errors in both adult and pediatric patients. The risk of bias for each study was assessed using the Newcastle-Ottawa Scale.Results One thousand five-hundred and fifty-eight titles or abstracts were screened, and 56 full-text studies were assessed for eligibility; eight studies were included in the final analysis. Case reports and retrospective studies were excluded. The quality of most studies (n = 6) was graded as ''low''. There were three categories of interventions: I) multimodal interventions (6 studies, n = 900,170

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“…removal of manual end of shift controlled-medication counting) were viewed positively by nurses and saved time. Removing manual counting, however, resulted in discrepancies going unnoticed and unaddressed for extended periods (Zheng et al, 2020). Reduction in errors associated with these systems most commonly relate to improvement in wrong-time errors rather than, the anticipated, reduction in errors causing harm (Cottney, 2014).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Implementation of distributed automated medication dispensing units in a new hospital: Nursing and pharmacy experience

Craswell

Bennett

Hanson

et al. 2021

Journal of Clinical Nursing

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Aims and objectives: To explore the structures, processes and outcomes involved in an Automated Medication Dispensing system implementation and its impact on patient safety.Background: Increasing digitalisation of medication prescribing, dispensing, administration and stock management has occurred over the past two decades. While automated medication dispensing units aim to provide safe, high-quality, patient-centred care, the implementation may result in unintended consequences leading to suboptimal outcomes.Design: This study uses a qualitative approach guided by Donabedian's structure, process and outcome framework.Methods: Twenty-six registered nurses and pharmacy assistant staff, from clinical areas equipped with automated medication dispensing cabinets, participated in semi-structured interviews. In-depth, thematic analysis explored the structures and processes. Together with interview data, content analysis of text data generated by internal risk management and critical incident reporting systems was undertaken to evaluate outcomes. Findings were considered in light of the Interactive Sociotechnical Analysis approach to health information technology. The COREQ checklist was used in preparation of this article.Results: Pharmacy assistants reported better satisfaction with the system at implementation than nurses. Training provided for nurses and their involvement in system implementation was reported as insufficient; however, nurses' use of and satisfaction with the system improved over time. A recursive relationship between the changes imposed by the system and nurses' creative problem solving (workarounds) used to manage these changes, impacted work productivity for nurses and safety for patients. Conclusions:The individualised nature of "workarounds" employed offered both risks and opportunities which require further identification, investigation and management.Relevance to clinical practice: Nurses are the majority of the health workforce.Digitalisation of traditionally paper-based activities in health care, impacting nursing work, requires similar strategies to any practice change.

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The impact of introducing automated dispensing cabinets, barcode medication administration, and closed-loop electronic medication management systems on work processes and safety of controlled medications in hospitals: A systematic review

Cited by 39 publications

References 40 publications

Evaluation of Medication Errors in a Tertiary Care Hospital of a Low- to Middle-Income Country

Evaluation of Medication Errors in a Tertiary Care Hospital of a Low- to Middle-Income Country

Interventions to reduce medication errors in anesthesia: a systematic review

Implementation of distributed automated medication dispensing units in a new hospital: Nursing and pharmacy experience

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