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Evaluation of medication dose omissions amongst inpatients in a hospital using an electronic Medication Management System.
- Source :
-
Journal of evaluation in clinical practice [J Eval Clin Pract] 2018 Aug; Vol. 24 (4), pp. 688-694. Date of Electronic Publication: 2018 May 22. - Publication Year :
- 2018
-
Abstract
- Rationale, Aims, and Objectives: Whilst many dose omissions cause no patient harm, inappropriate dose omissions have been associated with increased length of hospital stay, risk of sepsis, and mortality. This study aimed to comprehensively describe the prevalence and nature of omitted doses overall and of high risk medication dose omissions in an organization using an electronic Medication Management System.<br />Methods: A retrospective cross-sectional study was undertaken in an Australian tertiary referral health service. All routinely documented electronic inpatient dose administration records from 1 <superscript>st</superscript> July 2014 to 30 <superscript>th</superscript> June 2015 were included. Period prevalence and characteristics of dose omissions overall and of high-risk medication dose omissions were determined.<br />Results: During the study period, 3.3 million inpatient doses were scheduled for administration, with doses endorsed as "not given" comprising 6.2% of all scheduled doses. Non-valid dose omissions (medication not available or no justification documented) comprised 1.2% of scheduled doses. Patient refusal accounted for one third of all dose omissions, while for 12% no explanation was provided and 7% were endorsed "medication not available". High-risk medications accounted for 20% of all dose omissions. One in 20 antimicrobial doses scheduled were omitted, and of these, 17% were due to patient refusal.<br />Conclusion: The period prevalence of dose omissions in this large study after electronic Medication Management System implementation is similar to that found when paper charts were used. Although most dose omissions appear appropriate, many orders were not given due to patient refusal or with no documented justification. Interventions to minimize unintentional dose omissions are indicated.<br /> (© 2018 John Wiley & Sons, Ltd.)
- Subjects :
- Australia epidemiology
Cross-Sectional Studies
Humans
Inpatients statistics & numerical data
Length of Stay statistics & numerical data
Medication Systems, Hospital organization & administration
Prevalence
Retrospective Studies
Clinical Pharmacy Information Systems statistics & numerical data
Electronic Prescribing statistics & numerical data
Medical Errors prevention & control
Medical Errors statistics & numerical data
Medical Order Entry Systems statistics & numerical data
Medication Errors prevention & control
Medication Errors statistics & numerical data
Medication Therapy Management organization & administration
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2753
- Volume :
- 24
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of evaluation in clinical practice
- Publication Type :
- Academic Journal
- Accession number :
- 29786928
- Full Text :
- https://doi.org/10.1111/jep.12944