eprintid: 1569763 rev_number: 21 eprint_status: archive userid: 608 dir: disk0/01/56/97/63 datestamp: 2017-08-15 16:21:30 lastmod: 2021-09-25 23:10:09 status_changed: 2017-08-15 16:21:30 type: article metadata_visibility: show creators_name: Jheeta, S creators_name: Franklin, BD title: The impact of a hospital electronic prescribing and medication administration system on medication administration safety: an observational study ispublished: pub divisions: UCL divisions: B02 divisions: C08 divisions: D10 divisions: G11 keywords: Electronic prescribing, Hospital, Medication errors, Observational study note: Copyright © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. abstract: BACKGROUND: The aim of the study was to explore the impact of the implementation of an electronic prescribing and medication administration system (ePA) on the safety of medication administration in an inpatient hospital setting. Objectives were to compare the prevalence and types of: 1) medication administration errors, and 2) documentation discrepancies, between a paper and an ePA system. Additionally, we wanted to describe any observed changes to medication administration practices. METHODS: The study was based on an elderly medicine ward in an English hospital. From December 2014 to June 2015, nurses' medication administration rounds were observed every 5 days before and after ePA implementation using an interrupted time-series approach. Medication administration error and documentation discrepancy rates pre- versus post-ePA were analysed descriptively and chi-squared tests used to test for any difference; segmented regression analysis was used to determine changes in longitudinal trend. RESULTS: Observations were made at 15 pre- and 15 post-ePA implementation time-points. Pre-ePA on paper, there were 18 medication administration errors in 428 opportunities for error (4.2%; 95% confidence interval 2.3-6.1%), and with ePA there were 18 in 528 (3.4%; 95% confidence interval 1.9-5.0%; p = 0.64). Regarding documentation, pre-ePA on paper there were 5 discrepancies in 460 observed documentations (1.1%; 95% confidence interval 0.1-2.0%); with ePA there were 18 in 557 (3.2%; 95% confidence interval 1.8-4.7%; p = 0.04). The most common electronic documentation discrepancy was documentation that a dose had been administered when it had not. Segmented regression analysis was unable to detect any significant longitudinal changes. Changes to working practices post-ePA were observed, such as nurses demonstrating less-consistent self-checking when preparing and administering medications. CONCLUSIONS: Findings suggest no change in medication error rate, although ePA encourages certain types of errors and mitigates others. There was a statistically significant increase in documentation discrepancies which is likely to be due to adoption of new working practices with ePA. date: 2017-08-09 date_type: published official_url: http://doi.org/10.1186/s12913-017-2462-2 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1413155 doi: 10.1186/s12913-017-2462-2 pii: 10.1186/s12913-017-2462-2 lyricists_name: Franklin, Bryony lyricists_id: BFRAN90 actors_name: Smith, Daniel actors_id: DSMIT53 actors_role: owner full_text_status: public publication: BMC Health Services Research volume: 17 article_number: 547 event_location: England issn: 1472-6963 citation: Jheeta, S; Franklin, BD; (2017) The impact of a hospital electronic prescribing and medication administration system on medication administration safety: an observational study. BMC Health Services Research , 17 , Article 547. 10.1186/s12913-017-2462-2 <https://doi.org/10.1186/s12913-017-2462-2>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/1569763/1/document%2821%29.pdf