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Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors

Closed-loop electronic medication management systems (EMMS) have been seen as a potential technology to prevent medication errors (MEs), although the research on them is still limited. The aim of this paper was to describe the changes in reported MEs in Helsinki University Hospital (HUS) during and...

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Autores principales: Lindén-Lahti, Carita, Kivivuori, Sanna-Maria, Lehtonen, Lasse, Schepel, Lotta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222436/
https://www.ncbi.nlm.nih.gov/pubmed/35742071
http://dx.doi.org/10.3390/healthcare10061020
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author Lindén-Lahti, Carita
Kivivuori, Sanna-Maria
Lehtonen, Lasse
Schepel, Lotta
author_facet Lindén-Lahti, Carita
Kivivuori, Sanna-Maria
Lehtonen, Lasse
Schepel, Lotta
author_sort Lindén-Lahti, Carita
collection PubMed
description Closed-loop electronic medication management systems (EMMS) have been seen as a potential technology to prevent medication errors (MEs), although the research on them is still limited. The aim of this paper was to describe the changes in reported MEs in Helsinki University Hospital (HUS) during and after implementing an EPIC-based electronic health record system (APOTTI), with the first features of a closed-loop EMMS. MEs reported from January 2018 to May 2021 were analysed to identify changes in ME trends with quantitative analysis. Severe MEs were also analysed via qualitative content analysis. A total of 30% (n = 23,492/79,272) of all reported patient safety incidents were MEs. Implementation phases momentarily increased the ME reporting, which soon decreased back to the earlier level. Administration and dispensing errors decreased, but medication reconciliation, ordering, and prescribing errors increased. The ranking of the TOP 10 medications related to MEs remained relatively stable. There were 92 severe MEs related to APOTTI (43% of all severe MEs). The majority of these (55%, n = 53) were related to use and user skills, 24% (n = 23) were technical failures and flaws, and 21% (n = 21) were related to both. Using EMMS required major changes in the medication process and new technical systems and technology. Our medication-use process is approaching a closed-loop system, which seems to provide safer dispensing and administration of medications. However, medication reconciliation, ordering, and prescribing still need to be improved.
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spelling pubmed-92224362022-06-24 Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors Lindén-Lahti, Carita Kivivuori, Sanna-Maria Lehtonen, Lasse Schepel, Lotta Healthcare (Basel) Article Closed-loop electronic medication management systems (EMMS) have been seen as a potential technology to prevent medication errors (MEs), although the research on them is still limited. The aim of this paper was to describe the changes in reported MEs in Helsinki University Hospital (HUS) during and after implementing an EPIC-based electronic health record system (APOTTI), with the first features of a closed-loop EMMS. MEs reported from January 2018 to May 2021 were analysed to identify changes in ME trends with quantitative analysis. Severe MEs were also analysed via qualitative content analysis. A total of 30% (n = 23,492/79,272) of all reported patient safety incidents were MEs. Implementation phases momentarily increased the ME reporting, which soon decreased back to the earlier level. Administration and dispensing errors decreased, but medication reconciliation, ordering, and prescribing errors increased. The ranking of the TOP 10 medications related to MEs remained relatively stable. There were 92 severe MEs related to APOTTI (43% of all severe MEs). The majority of these (55%, n = 53) were related to use and user skills, 24% (n = 23) were technical failures and flaws, and 21% (n = 21) were related to both. Using EMMS required major changes in the medication process and new technical systems and technology. Our medication-use process is approaching a closed-loop system, which seems to provide safer dispensing and administration of medications. However, medication reconciliation, ordering, and prescribing still need to be improved. MDPI 2022-05-31 /pmc/articles/PMC9222436/ /pubmed/35742071 http://dx.doi.org/10.3390/healthcare10061020 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lindén-Lahti, Carita
Kivivuori, Sanna-Maria
Lehtonen, Lasse
Schepel, Lotta
Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title_full Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title_fullStr Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title_full_unstemmed Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title_short Implementing a New Electronic Health Record System in a University Hospital: The Effect on Reported Medication Errors
title_sort implementing a new electronic health record system in a university hospital: the effect on reported medication errors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222436/
https://www.ncbi.nlm.nih.gov/pubmed/35742071
http://dx.doi.org/10.3390/healthcare10061020
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