Abstract
Medication errors are common medical errors in healthcare settings that often lead to patient harm. Medication errors transpire during ordering, administration, and transcription of medications. Healthcare information technology is a promising strategy for prevention of these errors. In this paper, an article that reports on the application of technology to prevent medication errors was analyzed. The article is entitled “Effect of bar-code technology on the safety of medication administration”. It is authored by Poon et al. (2010) and reports on the methods and findings of a study that examined the impact of the use of eMAR technology on rates of timing and non-timing medication errors in medical, surgical, and intensive care units of a large academic hospital. The authors of the study sought to to bridge a knowledge gap as the existing evidence on the effectiveness of eMAR technology was limited and mixed. It utilized a pre-and post-implementation quasi-experimental research design. It found that eMAR lowered the rates of observed administration as well as transcription errors. Based on their qualifications, the researchers who conducted the study have authority to report on the topic. They include the shortcomings of their study. The findings of this study have significance for both clinical practice and future research.
Medication errors are common occurrences in hospitals and frequently cause harm to patients. They occur during the ordering, administration, and transcription stages of the medication process. It is estimated that a quarter of all medication errors that lead to adverse events are avoidable. Healthcare information technology is seen as a promising means of preventing medication errors (Poon et al., 2010). This paper will analyze an article on current technology for prevention of medication errors. The article is authored by Poon et al. (2010) and is entitled “Effect of bar-code technology on the safety of medication administration”.
The article is authored by 15 researchers with qualifications in public health, nursing (masters and baccalaureate), and medicine. The authors, therefore, have authority to write on the subject of medication errors. The title of the paper captures the main gist of the article and gives readers information on to what to expect when reading the article. The authors are addressing the general medical community consisting of doctors, nurses, hospital administrators, and other health professionals. The article is well organized and has been divided into various sections that are background, methods, results, and conclusions. These sections are concisely summarized in the abstract section of the article.
The study sought to assess the impact of bar-code technology on medication errors in medical, surgical, and intensive care units of a large tertiary academic medical center. It aimed to fill a knowledge gap as the evidence on the effectiveness of bar code electronic medication-administration (eMAR) technology is limited and mixed. It employed a quasi-experimental before-and-after design whereby the researchers assessed rates of medication errors in hospital units prior to and after implementation of the bar-code eMAR technology. The study was conducted over a 9-month period. The researchers observed a total of 14,041 instances of administration of medications and reviewed 3082 order transcriptions. Medication errors in the study were clustered into timing and non-timing errors. The researchers observed 776 non-timing medication administration errors in units that were not using the bar-code eMAR versus 495 similar errors in units that were using the technology (11.5 vs 6.8% error rate) which represented a relative decrease of 41.4% in medication errors (P<0.001). A reduction was also observed in the proportion of potential adverse drug events not linked to timing errors with the use of the bar-code verification technology (3.1% to 1.6%). This represented a relative reduction of 50.8% (P<0.001). The percentage of timing errors in the administration of medications reduced by 27.3% (P<0.001). There was, however, no significant change in the proportion of potential adverse drug events linked to timing errors. Lastly, the rate of transcription errors that occurred in units that were not utilizing the bar-code eMAR was 6.1%. These errors were, however, eliminated completely in the units that were using the technology.
On the issue of sources, grammar, and limitations, the authors use a mixture of primary and secondary sources to back their study. Some of the articles were fairly recent (2 years from date of being published) whilst others were quite old (more than 10 years old). There are no notable problems with the word usage, sentence structure, and grammar used in the article. The researchers describe several limitations of their study such as the fact that bias may have been introduced due to Hawthorne’s effect whereby participants under observation tend to perform better because they know they are being watched. Others included the fact that the study was only conducted in one hospital that already had the computerized-physician order entry system in place and only potential but not actual adverse drug events were examined during the study. The findings of the study have, however, potential utility as they suggest that the bar-code eMAR technology can improve the safety of medication by decreasing transcription and administration errors.
In summary, this paper has analyzed the article by Poon et al. (2010) entitled “Effect of bar-code technology on the safety of medication administration”. The article reports on a study that assessed the impact of eMAR technology on safety of medication administration in several units of an academic hospital. The study employed a quasi-experimental pre-and-post implementation research design. It established that the health information technology reduced the rates of observed administration and transcription errors. The authors of the study have authority to report on the study. The article is well organized and has no grammatical errors. The authors state the limitations of their study. The findings of the study have implications for clinical practice and research.
References
Poon, E. G., Keohane, C. A., Yoon, C. S., Ditmore, M., Bane, A., Levtzion-Korach, O., Moniz, T., Rothschild, J. M., Kachalia, A. B., Hayes, J., Churchill, W. W., Lipsitz, S., Whittlemore, A. D., Bates, D. W., & Gandhi, T. K. (2010). Effect of bar-code technology on the safety of medication administration. The New England Journal of Medicine, 362, 1698-1707.
