Use of a Handheld Computer Application for Voluntary Medication Event Reporting by Inpatient Nurses and Physicians

VA San Diego Healthcare System, San Diego, CA 92161, USA.
Journal of General Internal Medicine (Impact Factor: 3.42). 05/2008; 23(4):418-22. DOI: 10.1007/s11606-007-0404-0
Source: PubMed


To determine the feasibility of capturing self-reported medication events using a handheld computer-based Medication Event Reporting Tool (MERT).
Handheld computers operating the MERT software application were deployed among volunteer physician (n = 185) and nurse (n = 119) participants on the medical wards of four university-affiliated teaching hospitals. Participants were encouraged to complete confidential reports on the handheld computers for medication events observed during the study period.
Demographic variables including age, gender, education level, and clinical experience were recorded for all participants. Each MERT report included details on the provider, location, timing and type of medication event recorded. Over the course of 2,311 days of clinician participation, 76 events were reported; the median time for report completion was 231 seconds. The average event reporting rate for all participants was 0.033 reports per clinician shift. Nurses had a significantly higher reporting rate compared to physicians (0.045 vs 0.026 reports/shift, p = .02). Subgroup analysis revealed that attending physicians reported events more frequently than resident physicians (0.042 vs 0.021 reports/shift, p = .03), and at a rate similar to that of nurses (p = .80). Only 5% of MERT medication events were reported to require increased monitoring or treatment.
A handheld-based event reporting tool is a feasible method to record medication events in inpatient hospital care units. Handheld reporting tools may hold promise to augment existing hospital reporting systems.

Download full-text


Available from: Thomas Rutledge, Oct 07, 2015
14 Reads
  • Source
    • "All data collected was de-identified and participant responses remained anonymous to study investigators. Additional site and recruitment information has been previously described (Dollarhide et al., 2008; Rutledge et al., 2009; Stucky et al., 2009). All participants provided written informed consent, and Institutional Review Board (IRB) approval was obtained at each hospital. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Reducing medical error is critical to improving the safety and quality of healthcare. Physician stress, fatigue, and excessive workload are performance-shaping factors (PSFs) that may influence medical events (actual administration errors and near misses), but direct relationships between these factors and patient safety have not been clearly defined. This study assessed the real-time influence of emotional stress, workload, and sleep deprivation on self-reported medication events by physicians in academic hospitals. During an 18-month study period, 185 physician participants working at four university-affiliated teaching hospitals reported medication events using a confidential reporting application on handheld computers. Emotional stress scores, perceived workload, patient case volume, clinical experience, total sleep, and demographic variables were also captured via the handheld computers. Medication event reports (n = 11) were then correlated with these demographic and PSFs. Medication events were associated with 36.1% higher perceived workload (p < .05), 38.6% higher inpatient caseloads (p < .01), and 55.9% higher emotional stress scores (p < .01). There was a trend for reported events to also be associated with less sleep (p = .10). These results confirm the effect of factors influencing medication events, and support attention to both provider and hospital environmental characteristics for improving patient safety.
    Journal for Healthcare Quality 03/2013; 36(5). DOI:10.1111/jhq.12012 · 1.40 Impact Factor
  • Source
    • "Medication incident reporting (MIR) offers care providers a means to describe and document incidents that result from system failures [15-17]. It is a core initiative in improving resident safety [18-20]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.
    BMC Geriatrics 11/2012; 12(1):67. DOI:10.1186/1471-2318-12-67 · 1.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Handhelds and smart Personal Digital Assistants' (PDAs) use and applications have been growing exponentially. Their mobility and increasing computing power have made them attractive for use in daily life. Many electronic applications on such devices have been developed for healthcare and life sciences. Educational use for medical and health profession students have been suggested [1]. The goal of this paper is to overview three examples of how handhelds and PDAs are used in a healthcare context. This article combines three review articles published at Mobile Medical Computing Online journal.
Show more