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Hospital Medication Administration Errors: Their simulation, observation and severity assessment

Dean, B; (1999) Hospital Medication Administration Errors: Their simulation, observation and severity assessment. Doctoral thesis , University of London. Green open access

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Abstract

Background: Medication administration errors (MAEs) occur in about 5% of all doses given in UK hospitals. However, there are several reasons why existing methods for studying MAEs are inadequate. The aims of this research were to investigate the use of mathematical modelling to study MAEs and to develop a method for assessing MAE severity. Methods: A discrete-event simulation model was developed to represent the hospital drug distribution system. The model was used to investigate the effects of different changes to the system on unavailability-related MAEs (U-MAEs), the most common type of MAE in UK hospitals. A new method for assessing the severity of MAEs was developed; this was shown to be valid, reliable and practical for use in observation-based studies. A patients' own drugs (PODs) system, one of the systems tested using the model, was introduced on two study wards; an observation-based method was used to identify MAEs before and after its introduction. The U-MAE rates identified were compared to those predicted by the model. Other types of MAE (0-MAEs) were studied and MAE severity assessed. Results: The model's results suggested that the PODs system would reduce U-MAEs on each ward. However, this did not occur in practice. Four reasons for this finding were identified; three of these relate to assumptions made during model construction that hospital procedures would be followed. Had these four factors not existed, the real world U-MAE rates would have been very similar to those predicted by the model. There was no effect of the PODs system on the overall MAE rate or on MAE severity. Conclusions: Mathematical modelling is a potentially useful approach to the study of U-MAEs, although the model developed needs some further refinements. The introduction of a PODS system had no effect on the incidence or severity of MAEs.

Type: Thesis (Doctoral)
Title: Hospital Medication Administration Errors: Their simulation, observation and severity assessment
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
URI: http://discovery.ucl.ac.uk/id/eprint/1501051
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