Workflow standardization is essential in the healthcare setting due to the importance of preserving high-quality service at all times. Since patient health, well-being, and life are at stake, the validation of appropriateness and efficiency of nursing workflow is pivotal. Moreover, when dealing with such a responsible issue as medication administration, which is a routine but highly laborious procedure, the nursing workflow should be impeccable. This case study aims at reviewing the particularities of the computerized provider order entry (CPOE) use in nursing medication administration workflow. It is argued that the use of a more diverse methodology, automation of particular steps, and improvement of data display might enhance nursing workflow and minimize medication errors.
The use of relevant methods of data collection is an important aspect of any research project. In particular, the choice of methods should be validated by the data characteristics, research aims, and objectives, as well as the setting in which a study is conducted. In the case study, the researchers used a mixed method coupling observation and interviews; however, the research findings might benefit from using a different set of methods. For example, a method of experiment might be used to compare the time spent on medication administration by two groups of nurses, namely those working with CPOE and those handling paperwork (Van de Vreede et al., 2018). In addition, a method of observation might be used to collect data specifically related to errors in medication due to irrelevant CPOE use (Roumeliotis et al., 2019). Such data might be necessary to identify the weak points of the system and the opportunities for facilitating its design to minimize error occurrence in the hospital setting.
Moreover, a method of the survey might be implemented to collect nurses’ feedback on their experience with CPOE. This method might be more time-efficient in comparison to interviewing, which fits the requirements of conducting research on a site with time restrictions, such as hospitals. Overall, the integration of both qualitative and quantitative data collected using a variety of methods is a beneficial measure that would maximize study reliability and validity.
When displaying data on nursing workflow, illustrative means might be used to allow for viewing all necessary data at once. Tables and diagrams might be effective in demonstrating the workflow steps and the particularities faced by the staff when completing the medication administration with the use of CPOE. However, the most effective way of displaying workflow data is using dashboards. According to Dowding et al. (2019), “dashboards can reduce cognitive overload and improve users’ ability to interpret and remember relevant data” (p. 12). Moreover, when using a dashboard, a variety of relevant data might be displayed at once, available to the users at a glance. Since such data is easily edited and instantly visible to the users, the integration of dashboards in nurse workflow correction might have positive effects.
With the advancement of technologies and computerization, the processes become easier to complete, and routine tasks are accomplished more efficiently. However, the transition from manual medication administration to the implementation of CPOE might have its challenges due to the endured change the staff members with insufficient experience of automated system use might face. In particular, several changes to the workflow that occurred due to the CPOE implementation might jeopardize patient safety due to the elevated medication error risks (Romanow et al., 2018). For example, the case study holds that the nurses experienced difficulties in medication reconciliation which were challenging due to the automated system functioning. Such a problem might hinder the accuracy of medication prescription and is likely to result in a medication error. Furthermore, according to Page et al. (2017), the functioning of interrupting alerts in CPOE is an effective tool for medication error prevention. However, the changes implied in the case study’s system led to delays or the lack of alerts about stat orders, which hinders the safety of medication administration.
Automated steps of the nursing workflow might save time and enhance the speed and effectiveness of the routine medication administration process. In particular, among the many steps, checking for compatibility might be automated. Indeed, according to researchers, “weight- and age-based dosing calculation, renal dosing adjustment, screening for drug-drug interactions, administration scheduling” are the factors for error risks in manual administration (Roumeliotis et al., 2019, 2211). Thus, with the automation of these steps, not only will the time be saved but also errors prevented.
Conclusively, it is essential to minimize risks for errors in the healthcare setting to prioritize patient safety and well-being. Indeed, it is in Christian ethics to avoid harming others and prioritize good deeds at all times. Persistence and diligence are specifically praised in the Bible, which applies to the nursing responsibilities of minimizing medication errors in their workflow. According to Scripture, “if you pay attention to these laws and are careful to follow them, then the LORD your God will keep his covenant of love with you, as he swore to your ancestors” (Deuteronomy 7:12). Thus, preserving high standards of professionalism and minimization of errors by means of efficient and accurate use of CPOE guaranteed positive patient outcomes.
References
Dowding, D., Merrill, J. A., Barrón, Y., Onorato, N., Jonas, K., & Russell, D. (2019). Usability evaluation of a dashboard for home care nurses. Computers, Informatics, Nursing, 37(1), 11-19.
Page, N., Baysari, M. T., & Westbrook, J. I. (2017). A systematic review of the effectiveness of interruptive medication prescribing alerts in hospital CPOE systems to change prescriber behavior and improve patient safety. International Journal of Medical Informatics, 105, 22-30.
Roumeliotis, N., Sniderman, J., Adams-Webber, T., Addo, N., Anand, V., Rochon, P., Taddio, A., & Parshuram, C. (2019). Effect of electronic prescribing strategies on medication error and harm in hospital: a systematic review and meta-analysis. Journal of General Internal Medicine, 34(10), 2210-2223.
Romanow, D., Rai, A., & Keil, M. (2018). CPOE-enabled coordination: Appropriation for deep structure use and impacts on patient outcomes. MIS Quarterly, 42(1), 189-212.
Van de Vreede, M., McGrath, A., & de Clifford, J. (2018). Review of medication errors that are new or likely to occur more frequently with electronic medication management systems. Australian Health Review, 43(3), 276-283.