The use of prescription medicine is widespread, complex, and increasingly risky in the modern world. Advancement in medical research and technology means that clinicians currently have access to more than 10,000 prescription medications. Further, almost 33% of mature people in America consume five or more drugs. Although the advancement in clinical and medical knowledge base has led to improved health outcomes for patients with many diseases, the benefits are coupled with increased risks (Authority, 2014). Adverse Drug Events (ADE) refers to the harm caused in patients because of exposure to medication. ADEs account for more than 700,000 emergency department visits and more than 100,000 hospitalizations in the US alone. In the backdrop of the above statistics, medical practitioners are under pressure to provide solutions on how to avoid medication errors (Agrawal, 2014). One of the most proposed and viable ways of reducing the medication errors is through the adoption of technology. In this case, the use of Bar Codes, Smart Pumps, and Computerized Physician Order Entry (CPOE) reduces the rate of medication administration errors.
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Technology and Reduction of Medication Errors
The 21st-century healthcare sector has been characterized by significant progress in medical-related technologies that have contributed to better outcomes in the process of handling patients. Despite such technologies, medication errors continue to be a major subject that has unfortunately not been addressed well by technology (Poon et al., 2010). Some of the technologies that have the potential to eliminate medication mistakes include Smart Pumps and the CPOE among others.
The use of the bar-coding technology is widespread in the business environment where it is used to guarantee ease of tracking of a product in an organization from its entry to its exit from the inventory. Such technology is also very helpful in the healthcare sector. It can be used to reduce medication errors (Ammenwerth, Schnell-Inderst, Machan, & Siebert, 2008). The expertise brings additional authentication into the “five rights” of drug management that medical practitioners and clinicians are already conversant with. Such rights comprise the right patient, the right drug, the right prescription, the right method, and the right time. For example, when a provider makes an order that passes through the pharmacy system, the chemist assesses the item to determine whether any aversions or drug exchanges are present. Once the order is approved and the dosage schedule identified by the pharmacist, the information is passed forward through the electronic medication administration record system (eMAR) to the clinician/nurse (Poon et al., 2010). If any allergies are detected, the information is also entered and passed along the eMAR. In support of the use of Bar Codes, a study undertaken by the Institute of Medicine in 1999 found out that the technology ensured that the prescription was in the right dosage and for the appropriate customer (Pippins et al., 2008). Further, it also ensured that nurses could keep time through appropriate reminders. Consequently, it is important to adopt the use of the Bar Code technology to help in the reduction of medication errors in healthcare facilities.
Medication errors that occur through Intravenous (IV) infusion result in some of the serious repercussions on patients. Indeed, more than 60% of the life-threatening ADEs relate to IV infusion. Hence, in its 2006 report, the Institute of Medicine recommended that Smart Pumps would allow the precise medication that is best suited for patients without leading to any side effect (Reves, 2013). The Smart Pumps or intelligent infusion devices, which come with software, have an added advantage of eliminating potential errors (Agrawal, 2014). Such pumps make it easy for a medical facility to develop a database of prescriptions that provide drug procedures, which spell out the quantity, the application, and medical advisories. The libraries are programmed to specific needs of an organization or patients within a facility.
The pumps provide three different options for action during the infusion of drugs. The Smart Pumps offer medical recommendations. In medical recommendations, the pump can display messages that relate to the drug that a health officer can recommend to a patient. In Soft Stops, the pump stops in such a way that the user does not expose himself or herself to the potential risk of administering the drug out of the specified range. However, the alert can be overridden by the user in such a way that the drug is administered without changing the settings of the Smart Pump (Pippins et al., 2008). In hard stops, the Smart Pump notifies the user in a manner that he or she cannot go beyond the recommended medication limits.
The Smart Pumps offer an important advantage over the traditional pumps. Firstly, they can reduce the number of errors associated with miscalculated doses (Pippins et al., 2008). This goal can be achieved since the Smart Pumps can offer checks for labor-intensive computation, thus guaranteeing that the chosen amount is suitable for the prescription and the ailing person. The machine also retrieves and secures data in the process of drug administration. Such information can be used in the future for quality and service improvement efforts.
The Smart Pumps have several shortcomings, which must be addressed. Firstly, the technology is not perfect since it does not prevent the application of such medication on the wrong patient, despite the selection of the right dosage and quantities. However, such issue can be addressed using bar codes, which can assist in identifying appropriate customers and the right time for the administration (Poon et al., 2010). The precision of the Smart Pumps is also determined by the exact entry of the prescribed amount and the information that is available in the database. If the database contains wrong, missing, or inadequate information, then Smart Pumps cannot function appropriately. Instead, they can lead to more medication errors. The Soft Stops can easily be overridden, hence providing a potential avenue for medication errors.
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The CPOE allows the entry of medication orders or other physician instructions electronically as opposed to the traditional paper charts. One of the most important advantages of the use of CPOE is in reducing medication errors that relate to poor handwriting or transcription of medication orders (Pippins et al., 2008). The system imitates the workflow of paper charts, thus eliminating the error-prone use of paper charts. In addition, the use of the CPOE drastically reduces medication error rates while at the same time increasing clinically appropriate and cost-effective ordering and administration of medications and tests (Ammenwerth et al., 2008). The system can further provide decision support to clinicians, thus increasing the accuracy and appropriateness of care. However, there is the need to enter and generate information based on local consensus on the knowledge base and the rules that apply for decision support to work efficiently. The CPOE system can also be used to compute interactions between medication and laboratory outcomes, thus providing an important information center for correct medication dosage and administration.
Despite its advantages, the technology has several shortcomings. Firstly, the time factor is a major hindrance to its adoption. Many physicians complain that it takes more time to enter an order into the system as compared to the use of handwritten paper charts (Pippins et al., 2008). Further, as a new technology, many physicians have a problem transitioning from the traditional paper works to the new technology use provided by the CPOE (Authority, 2014). Consequently, even when the system is in place, doctors and physicians often ignore it and use the paper charts to make medication orders. The other disadvantage is the cost and time used to install the system to reach functional levels.
The paper has offered a detailed analysis that shows how medication errors continue to be a major concern for many healthcare sectors across the world. Technology has provided potential approaches and concepts that can be used to reduce the errors while increasing patients’ health outcomes. In this case, the use of Bar Code technology, Smart Pumps, and Computerized Physician Order Entry (CPOE) offers important alternatives to the use of technology in reducing medication errors in the healthcare sector. As discussed in the paper, it is important for medical facilities to adopt such technologies to protect the patient from medication errors that are responsible for a big number of hospitalizations in the United States and across the world.
Agrawal, A. (2014). Medication errors: prevention using information technology systems. British Journal of Clinical Pharmacology, 67(6), 681-686.
Ammenwerth, E., Schnell-Inderst, P., Machan, C., & Siebert, U. (2008). The effect of electronic prescribing on medication errors and adverse drug events: a systematic review. Journal of the American Medical Informatics Association, 15(5), 585-600.
Authority, P. (2014). Medication errors occurring with the use of bar-code administration technology. Pennsylvania Patient Safety Advisory, 5(4), 122-126.
Pippins, J., Gandhi, T., Hamann, C., Ndumele, C., Labonville, S., Diedrichsen, E., & Liang, C. (2008). Classifying and predicting errors of inpatient medication reconciliation. Journal of general internal medicine, 23(9), 1414-1422.
Poon, E., Keohane, C., Yoon, C., Ditmore, M., Bane, A., Levtzion-Korach, O., & Churchill, W. (2010). Effect of bar-code technology on the safety of medication administration. New England Journal of Medicine, 362(18), 1698-1707.
Reves, J. (2013). Smart Pump Technology reduces Errors. Web.