Can new technologies reduce the rate of medication errors in adult intensive care?

Original title: Les nouvelles technologies permettent-elles de réduire les erreurs médicamenteuses en soins intensifs adultes?

Original article by: E Benoit, J Beney

Reference: Journal de Pharmacie de Belgique Sep 2011;(3):82-91

Source: Journal de Pharmacie de Belgique

Keywords: Automation; Bar Codes; Critical Care; Dispensing; Errors-Medication; Errors-Prescribing; Information Technology; Infusion Pumps; Intensive Care Unit; Medication Records; Patient Safety; Review;

Date published: 19/12/2011 15:28

Summary
by: Pharm-line

Technology to control the monitoring and administration of critical drugs to unstable patients is widespread in the intensive care environment.  Since the early 2000s computerised physician order entry (CPOE), bar code assisted medication administration (BCMA), 'smart' infusion pumps (SIP), electronic medication administration records (eMAR) and automated dispensing systems (ADS) have been recommended to reduce medication errors.  Some 10 years later, the extent to which they have been adopted is increasing but is still modest.  The objective of this study is to determine the impact of these technologies on the rate of medication errors (ME) in adult intensive care.  CPOE permits a marked and significant reduction in ME, especially the least critical ones.  Only by adding a clinical decision support system (CDSS), can CPOE achieve a reduction in serious errors.  Used alone, it could even increase them.  The available studies do not have sufficient power to demonstrate the benefits of SIP or BCMA on ME.  However, practices such as overriding of alerts have been demonstrated with these devices.  Power or methodology problems and conflicting results do not allow the ability of ADS to reduce the incidence of ME in intensive care to be established.  Studies investigating such technologies are not very recent, are of limited number and show defects in their methodology, which does not allow us to determine whether they can reduce the incidence of MEs in the adult intensive care.  Currently, the benefits appear to be limited which may be explained by the complexity of their integration into the care process.  Special attention should be given to the communication between caregivers, the human-computer interface and the training of caregivers.

About this library entry
Category: Adult | IT | Medication errors

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