Effect of a closed-loop medication order executive system on safe medication administration at a tertiary hospital: a quasi-experimental study.

Background

Closed-loop electronic medication management systems are effective measures for preventing medication errors (MEs). However, there is limited evidence supporting this, and few studies have evaluated the long-term effects of these systems on safe medication.

Objective

To evaluate the long-term effects of implementing a closed-loop medication order executive system on the safe clinical use of medications.

Design

A quasi-experimental design.

Method

Data from 2017 to 2023 were extracted and retrospectively analyzed. The primary outcome indicator was the ME rate. Secondary outcome indicators were the accuracy of order verification and patient identification and the implementation rate of fresh medicine dispensing. The autoregressive integrated moving average (ARIMA) model in time-series analysis was used to evaluate the level and trend changes in ME rates using SPSS 25.0 before and after system implementation. Root cause analysis and descriptive statistics were used to assess changes in types, stages, and causes of ME rates. The independent samples

Results

Overall, 295 MEs were reported with a mean of 0.26 ± 0.26 ME rates per month during 2017-2023. The ARIMA model showed a decrease in the average level of ME rates after system implementation, with no statistically significant decrease in the long term, and a significant drop in the ME rate in the short and medium term (

Conclusion

Adopting a closed-loop executive system is beneficial for ensuring patient medication safety, but a single integrated system does not completely eliminate MEs. Optimizing system functionalities and applying structured handoff tools are recommended to meet clinical needs and enhance system usability.

The study used some quality management indicators to evaluate the effect of a medication order executive system on the safety of medication administration Why was the study done? Medication errors (MEs) may cause harm to patients. A medication order execution system can effectively prevent MEs, but its long-term effects have not been fully identified. What did the researchers do? The research team collected some quality management indicators at the Jiangsu Province Hospital, such as ME rates and accuracy of patient identification, from pre-implementation to post-implementation in the short, medium, and long term. What did the researchers find? The use of the system significantly reduced ME rates, especially in the short term. The accuracy and timeliness of execution of medication orders were improved. What do the findings mean? The system can ensure the safety of medication administration to a certain extent, but the prevention and control of human risks are limited. The system can still be continuously improved by optimizing the functions of the system and using tools to further reduce the occurrence of adverse events.

Informations de copyright

© The Author(s), 2024.