Validation of a mobile app for reducing errors of administration of medications in an emergency

Abstract

Medication errors occur frequently and are a risk to patient safety. To reduce mistakes in the medication process in emergencies, a mobile app has been developed supporting the calculation of doses and administration of drugs. A simulation study was performed to validate the app as a tool to reduce medication errors. This was a randomised crossover study conducted in the Academic Hospital. The participants included were residents and attendings in anaesthesiology. 74 Participants performed four simulation scenarios in which they had to calculate and administer drugs for emergencies. Two scenarios were performed with the app ("app scenarios") and the other two scenarios were performed without the use of the app ("control scenarios"). The order of drugs, simulation patients and usage of aid were randomized. The accuracy of administered drug doses were measured. Medications were categorised as either "accurate" ([Formula: see text]% of target dosage) or "wrong" (less than 50% or more than 200% of target dosage). The dosage calculated and the dosage administered were documented separately to differentiate between calculation and handling errors. During app scenarios, there were no "wrong" dosages, whereas 6.8 (95% CI 2.7-10.8%) of dosages in control scenarios were evaluated as "wrong". The probability of giving an "accurate" dosage was increased from 77.7 (70.9-84.5%) in control scenarios to 93.9 (90-97.8%) in app scenarios. Calculation errors were the main cause for wrong dosing. The app is an appropriate and feasible tool to reduce calculation and handling errors and may increase patient safety.

Need Assessment and Development of a Mobile-based Medication Dosage Calculation Application for ICU nurses

“…Various studies [12][13][14][15][16] have shown that information and communication technology, particularly mobile devices, is used in all areas of health care, including drug dosage calculations. Currently, many people of different medical professions are using different mobile health applications and these have a positive effect on their activities and performance [15,17].…”

“…As ICU nurses are on the shift when administrating medication to the patient, they need a tool that can provide information quickly and easily. Studies which have used information and communication technology for drug dosage calculations involve anesthesiologists using mobile health applications [13], mobile health application for calculating drugs in pediatric cardiovascular resuscitation [25], and CPOE implementation [26,27].…”

Development and Preliminary Validation of LoAD Calc, a Mobile App for Calculating the Maximum Safe Single Dose of Local Anesthetics

“…Mobile apps or other mHealth solutions are being developed for many different interventions in healthcare. There has been a recent and significant increase in the development of solutions aiming to reduce errors surrounding prescription and drug administration [ 7 , 8 ]. This kind of technological intervention is easy to target, rather fast to develop and can lead to significant improvements in clinical practice and patient safety.…”

“…Most of them suggest doses that might exceed the maximum safe dose and give only general advice as to the caution with which their propositions should be used. The successful use of specific mobile health (mHealth) point of care decision-support tools focusing on drug administration has been described in other contexts, such as emergency settings [ 7 ], simulated pediatric cardiopulmonary resuscitation [ 8 ], as well as for the prescription of antibiotics [ 9 ].…”

Mobile Applications in Clinical and Perioperative Care for Anesthesia: Narrative Review

“…Finally, anesthesiologists have historically used smartphones to calculate drug dosages. Baumann et al compared the probability of administering accurate medication dosages in emergency simulations with a dosage calculator app versus without it [ 21 ]. The probability of an accurate dose administration was higher in the app group compared to the control group (94%, SD 90-97.8 vs 77.7%, SD 70.9-84.5) [ 21 ].…”