How Technology Impacts the Administration of Medication - Annotated Bibliography Example

Annotated Bibliography: How Technology Impacts the Administration of Medication Annotated Bibliography: How Technology Impacts the Administration of Medication Introduction As the number of patients admitted to a hospital increase, and staffing shortages continue to be an issue, the proper administration of medication within an acute care setting becomes of even great concern. The potential for human error when administrating medication is already high, but add in the stress of the modern day health care setting and this only seems to be compounded today. As a result, recent years have seen numerous technological advances in the area to automate the process of properly administering medication to patients in a variety of healthcare settings. With these advances, however, has come the need to ensure that medical professionals are adequately trained in the new tools, and that errors due to the failure of technology are minimized to the greatest extent possible. Out of this has arisen numerous medical studies to determine the actual impact that technology has on the administration of medication in today’s acute care setting, and that is the focus of this review of literature as well. Annotated Bibliography Abigail, A. (2011). Medication administration: Technology meets challenges, but training ensures success. Nursing Management, 42(12), 35. The author of this study implemented a unique approach in studying the efficacy of new technology in administering medication. Coming from the perspective that automating the process of medical administration can dramatically decrease potentially deadly error. the study analyzed the effect that training has on ensuring that the same mistakes do not happen at the hands of the very technology it is designed to help. Through observing and surveying nurses in a variety of healthcare settings, the author of this study concludes the types of training that prove most effective and alludes to the necessity of such training strategies before incorporating the use of technology into the overall process and procedure of administering medication throughout an acute care setting. Andersson, M., Axelsson, K., and Lindberg, I. (2014). Digital support for medication administration. Journal of Health Organization and Management, 28(3), 327-343. In looking at the efficacy of using technology to monitor the administration of medication, this study worked to describe the perceptions of various staff members in terms of their support for the digitization of the process. A total of 22 people working with the elderly in a care facilitated in the study. The staff that participated in this particular study sometimes expressed strong emotions as a sign of frustration for losing prerequisites to perform their work well. In big complex organizations where economy and effectiveness are often discussed, knowledge of power relations in innovation and implementation processes would be beneficial. Although moral distress is a well-known phenomenon, future research may be needed to find solutions that diminish this negative trend in more economic focussed organizations. Appari, A. (2012). Medication administration quality and health information technology: A national study of US hospitals. Journal of the American Medical Informatics Association, 19(3), 360-367. The purpose of this study to analyze whether or not the use of a computerized physician order entry and the implementation of an electronic medication administration records system actually leads to a better quality of medication administration at medium-to-large acute-care hospitals. The analysis itself focused on 11 quality indicators (January-December 2009) at 2603 medium-to-large, non-federal acute-care hospitals measuring proportion of eligible patients given (or prescribed) recommended medications for conditions, including acute myocardial infarction, heart failure, and pneumonia, and surgical care improvement. Using technology adoption by 2008 as reference, hospitals were coded by a design incorporated by the researchers. Hospitals were also coded for duration of use in 2-year increments since technology adoption. Hospital characteristics, historical measure-specific patient volume, and propensity scores for technology adoption were used to control for confounding factors. The analysis was performed using a generalized linear model (logit link and binomial family). This study was effective, as it concluded that the benefits are evident for adoption of both system based on various benchmark indicators obtained by this study. Bonkowski, J. (2014). Improving medication administration safety in solid organ transplant patients through barcode assisted medication administration. American Journal of Medical Quality, 29(3), 236-241. This particular study will be useful in the context of this literature review, as it looks at a specific area of medical treatment to determine the efficacy of using technology in the administration of medication. To better study this, it was based upon the findings that solid organ transplant recipients were prescribed a high number of medications, increasing the potential for medication errors. Barcode-assisted medication administration (BCMA) is a technology that reduces medication administration errors. This was an observational methodology that was conducted at an academic medical center solid organ transplant unit before and after BMCA implementation. Medication accuracy was determined and administration errors were categorized by type and therapeutic class of medication. The results of this study suggest that routinely adopting BCMA has the potential to reduce medication administration errors in transplant patients. Dwibedi, N. (2012). Bedside barcode technology: Impact on medication administration tasks in an intensive care unit. Hospital Pharmacy, 47(5), 360-366. One of the primary uses of modern technology is the incorporation of barcodes to properly administer medication in set doses and at predetermined intervals. Through a combination of patients having the proper barcode on their wrist and the medication lining up with the correct patient, the aim is for this technology to drastically reduce any incidences of administering the wrong medication to a patient, or giving the wrong dose of the correct medication at the wrong time. In addition, barcode technology is designed to minimize any incidences of a patient incorrectly begin given a medication that they have a predetermined allegory to. These, and more benefits, are mentioned in this study, yet the author makes the effective point that such technology is useless if it does not work properly. This study will be beneficial in the context of this impending literature review as it examines the specific impact that barcode technology has on the overall administration of medication with an intensive care unit in any given health care facility. Holden, R., Brown, R., Scanlon, M., and Karsh, B. (2012). Modeling nurses acceptance of bar coded medication administration technology at a pediatric hospital. Journal of the American Medical Informatics Association, 19(6), 1050-1058. This study sought to ascertain the degree to which nurses accepted the use of bar code technology to administer medication within a pediatric hospital. To identify predictors of nurses acceptance of bar coded medication administration (BCMA). This study used a cross-sectional survey of 83 registered nurses at an academic pediatric hospital that recently implemented BCMA. Surveys assessed seven BCMA-related perceptions: ease of use; usefulness for the job; social influence from non-specific others to use BCMA; training; technical support; usefulness for patient care; and social influence from patients/families. It was discovered that behavioral intention to use BCMA was high, but satisfaction was low. In addition, behavioral intention to use was best predicted by perceived ease of use, perceived social influence from non-specific others, and perceived usefulness for patient care (56% of variance explained). This study will prove effective in the context of this literature review because the success with BCMA and other technologies can benefit from assessing end-user acceptance and elucidating the factors promoting acceptance and use. Madhu, S. (2013). Safe medication administration. Nursing Journal of India, 104(4), 179. The author of this study implemented a unique approach in studying the efficacy of new technology in administering medication. Coming from the perspective that automating the process of medical administration can dramatically decrease potentially deadly error. the study analyzed the effect that training has on ensuring that the same mistakes do not happen at the hands of the very technology it is designed to help. Through observing and surveying nurses in a variety of healthcare settings, the author of this study concludes the types of training that prove most effective and alludes to the necessity of such training strategies before incorporating the use of technology into the overall process and procedure of administering medication throughout an acute care setting. Miller, D., Fortier, C., and Garrison, K. (2011). Bar code medication administration technology: Characterization of high-alert medication triggers and clinician workarounds. Annals of Pharmacotherapy, 8(1), 2-20. One of the primary uses of modern technology is the incorporation of barcodes to properly administer medication in set doses and at predetermined intervals. Through a combination of patients having the proper barcode on their wrist and the medication lining up with the correct patient, the aim is for this technology to drastically reduce any incidences of administering the wrong medication to a patient, or giving the wrong dose of the correct medication at the wrong time. In addition, barcode technology is designed to minimize any incidences of a patient incorrectly begin given a medication that they have a predetermined allegory to. These, and more benefits, are mentioned in this study, yet the author makes the effective point that such technology is useless if it does not work properly. This study will be beneficial in the context of this impending literature review as it examines the specific impact that barcode technology has on the overall administration of medication in alerting physicians to possible high-alert situations, resulting in clinicians possibly being able to develop a plausible workaround. Prusch, A., Suess, T., Paoletti, R., Olin, S., and Watts, S. (2011). Integrating technology to improve medication administration. American Journal of Health-System Pharmacy, 68(9), 835-842. The development, implementation, and evaluation of an i.v. interoperability program to advance medication safety at the bedside are described. I.V. interoperability integrates intelligent infusion devices (IIDs), the bar-code-assisted medication administration system, and the electronic medication administration record system into a bar-code-driven workflow that populates provider-ordered, pharmacist-validated infusion parameters on IIDs. The purpose of this project was to improve medication safety through the integration of these technologies and decrease the potential for error during i.v. medication administration. Four key phases were essential to developing and implementing i.v. interoperability: (a) preparation, (b) i.v. interoperability pilot, (c) preliminary validation, and (d) expansion. The establishment of pharmacy involvement in i.v. interoperability resulted in two additional safety checks: pharmacist infusion rate oversight and nurse independent validation of the autoprogrammed rate. After instituting i.v. interoperability, monthly compliance to the telemetry drug library increased to a mean ± S.D. of 72.1% ± 2.1% from 56.5% ± 1.5%, and the medical-surgical nursing units drug library monthly compliance rate increased to 58.6% ± 2.9% from 34.1% ± 2.6% (p < 0.001 for both comparisons). The number of manual pump edits decreased with both telemetry and medical-surgical drug libraries, demonstrating a reduction from 56.9 ± 12.8 to 14.2 ± 3.9 and from 61.2 ± 15.4 to 14.7 ± 3.8, respectively (p < 0.001 for both comparisons). Through the integration and incorporation of pharmacist oversight for rate changes, the telemetry and medical-surgical patient care areas demonstrated a 32% reduction in reported monthly errors involving i.v. administration of heparin. By integrating two stand-alone technologies, i.v. interoperability was implemented to improve medication administration. Medication errors were reduced, nursing workflow was simplified, and pharmacists became involved in checking infusion rates of i.v. medications. Seibert, H., Maddox, R., Flynn, E., and Williams, C. (2014). Effect of barcode technology with electronic administration record on medication accuracy rates. American Journal of Health-System Pharmacy, 71(3), 209-218. The effect of barcode-assisted medication administration (BCMA) with electronic medication administration record (eMAR) technology on the occurrence of medication administration errors was evaluated in this particular study. The methodology incorporated both a pretest and posttest nonequivalent comparison group was used to investigate the effect of BCMA-eMAR on the medication administration accuracy rates at two community-based hospitals. Patient care units included three matched pairs in the two hospitals—two medical–surgical, two telemetry, and two rehabilitation units—plus a medical–surgical intensive care unit, an emergency department, and both an inpatient oncology unit and an outpatient oncology service at one of the hospitals. Medication administration accuracy rates were observed and recorded before (phase 1) and approximately 6 and 12 months after (phases 2 and 3, respectively) the implementation of BCMA-eMAR. RESULTSThe overall accuracy rate at hospital 1 increased significantly from phase 1 (89%) to phase 3 (90%) (p = 0.0015); if wrong-time errors are excluded, the accuracy rate improved from 92% in phase 1 to 96% in phase 3 (p = 0.000008). The overall accuracy rate did not change significantly from phase 1 to phase 3 at hospital 2; when wrong-time errors were excluded from consideration, the accuracy rate improved from 93% in phase 1 to 96% in phase 3 (p = 0.015). The conclusion to this study illustrates that the implementation of BCMA-eMAR in two hospitals was associated with significant increases in total medication accuracy rates in most study units and did not introduce new types of error into the medication administration process. Accuracy rates further improved when wrong-time errors were excluded from analysis. The frequency of errors preventable by BCMA-eMAR decreased significantly in both hospitals after implementation of that technology. BCMA-eMAR and direct observation were more effective than voluntary reporting programs at intercepting and recording errors and preventing them from reaching patients. Wulff, K. (2011). Medication administration technologies and patient safety: A mixed method systematic review. Journal of Advanced Nursing, 67(10), 2080-2095. Systematic reviews are beneficial within the scope of this study because they combine the analysis of multiple articles to determine what current reality appears to be. This particular paper looks at the correlation between patient safety and the administration of medication. Healthcare leaders need evidence-based information on nursing medication administration technologies to guide the design of improvements to patient safety. The aim of this study was to evaluate the research evidence on relationships between the use of medication administration technologies and incidence of medication administration incidents and preventable adverse drug events to inform decision-making about existing technology options. Thirteen electronic databases and seven relevant patient safety websites were searched for the years 1980-2009. Twelve studies (two qualitative, five pre- and postinterventions and five correlational) met the inclusion criteria. All were assessed as medium quality with low generalizability of study findings. Only two studies sampled more than one hospital and none of the studies was driven by an explicit theoretical framework. The studies included in this review are generally positive towards medication administration technologies and their potential benefits, yet the level of evidence overall is equivocal. The majority of studies pointed to the development of workarounds by nurses following medication administration technology implementation that could compromise patient safety. More theoretically driven research is needed to determine which medication administration technologies should be implemented in what ways to most effectively reduce medication administration incidents and preventable adverse drug events and minimize the development of potentially unsafe workarounds. Further evidence is required to accurately assess the actual contribution of medication administration technologies for improving patient safety. Read More