The Pharmaceutical Journal
Vol 279 No 7471 p340
29 September 2007

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Integrated electronic systems improve safety

Patient safety in hospitals is increased by the use of integrated electronic medicines management systems, new research shows.

Combining electronic prescribing with automated dispensing, bar-coded administration and an electronic record of medication administration reduces prescribing and administration errors by almost half, according to the study from a London teaching hospital.

Data were collected three to six months before installation of the ServeRx system (manufactured by MDG Medical) and six to 12 months afterwards. The system was found to reduce prescribing errors by 47 per cent (from 3.8 per cent to 2 per cent) and reduce non-intravenous administration errors by 39 per cent, predominantly reducing wrong dose and omission errors.

The system also increased nurse checking of patient identity and may have resulted in more prescribing errors being corrected before administration. The time spent by pharmacy and medical staff dealing with medicines was found to increase, although the nursing time spent on drug rounds was reduced. The researchers point out that most data showing benefits of such systems come from the US, and this is the first UK study to examine the impact of such a “closed-loop” system (Quality and Safety in Healthcare 2007;16:279).

In an associated paper the researchers show how the system’s performance and functions have evolved since its installation in 2003, using an evaluation framework based on socio-technical theory (ie, how individuals and organisations adapt to the system over time).

Interviews and a focus group session were held with pharmacists, doctors, nurses and managers and the responses were analysed. They found that, in general, staff attitudes became more positive over time. Pharmacists with direct involvement in the project said that the system had helped them build close relationships with other clinical staff.

Pharmacists had a clearer idea than doctors and nurses of additional benefits of the system, such as it allowing more time for patient counselling (ibid, p271).