NDLI: Defining electronic-prescribing and infusion-related medication errors in paediatric intensive care

Content Provider	Springer Nature : BioMed Central
Author	Howlett, Moninne M. Cleary, Brian J. Breatnach, Cormac V.
Abstract	Background The use of health information technology (HIT) to improve patient safety is widely advocated by governmental and safety agencies. Electronic-prescribing and smart-pump technology are examples of HIT medication error reduction strategies. The introduction of new errors on HIT implementation is, however, also recognised. To determine the impact of HIT interventions, clear medication error definitions are required. This study aims to achieve consensus on defining as medication errors a range of either technology-generated, or previously unaddressed infusion-related scenarios, common in the paediatric intensive care setting. Methods This study was conducted in a 23-bed paediatric intensive care unit (PICU) of an Irish tertiary paediatric hospital. A modified Delphi technique was employed: previously undefined medication-incidents were identified by retrospective review of voluntary incident reports and clinical pharmacist interventions; a multidisciplinary expert panel scored each incident using a 9-point Likert scale over a number of iterative rounds; levels of agreement were assessed to produce a list of medication errors. Differences in scoring between healthcare professionals were assessed. Results Seventeen potential errors or ‘scenarios’ requiring consensus were identified, 13 of which related to technology recently implemented into the PICU. These were presented to a panel of 37 participants, comprising of doctors, nurses and pharmacists. Consensus was reached to define as errors all reported smart-pump scenarios (n = 6) and those pertaining to the pre-electronic process of prescribing weight-based paediatric infusions (n = 4). Of 7 electronic-prescribing scenarios, 4 were defined as errors, 2 were deemed not to be and consensus could not be achieved for the last. Some differences in scoring between healthcare professionals were found, but were only significant (p < 0.05) for two and three scenarios in consensus rounds 1 and 2 respectively. Conclusion The list of medication errors produced using the Delphi technique highlights the diversity of previously undefined medication errors in PICU. The increased complexity of electronic-prescribing processes is evident from the difficulty in achieving consensus on those scenarios. Reducing ambiguity in defining medication errors should assist future research on the impact of HIT medication safety initiatives in critical care. The increasing use of HIT and associated new errors will necessitate further similar studies.
Related Links	https://bmcmedinformdecismak.biomedcentral.com/counter/pdf/10.1186/s12911-018-0713-8.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726947
DOI	10.1186/s12911-018-0713-8
Journal	BMC Medical Informatics and Decision Making
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-12-07
Access Restriction	Open
Subject Keyword	Health Informatics Information Systems and Communication Service Management of Computing and Information Systems Paediatric intensive care Medication errors Patient safety Health information technology Medical order entry systems Infusion pumps Consensus
Content Type	Text
Resource Type	Article
Subject	Health Informatics Computer Science Applications Health Policy
Journal Impact Factor	3.3/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Smart pumps improve medication safety but increase alert burden in neonatal care

Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care - a systematic review

How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review

The impact of a novel medication scanner on administration errors in the hospital setting: a before and after feasibility study

Discrepancies between medication orders and infusion pump programming in a paediatric intensive care unit.

Building consensus about eHealth in Slovene primary health care: Delphi study

The Impact of Technology on Prescribing Errors in Pediatric Intensive Care: A Before and After Study

Has information technology finally been adopted in Flemish intensive care units?

AMDIS Case Conference: Intrusive Medication Safety Alerts.

Defining electronic-prescribing and infusion-related medication errors in paediatric intensive care – a Delphi study

Similar Documents

Smart pumps improve medication safety but increase alert burden in neonatal care

Risks to patient safety associated with implementation of electronic applications for medication management in ambulatory care - a systematic review

How intervention studies measure the effectiveness of medication safety-related clinical decision support systems in primary and long-term care: a systematic review

The impact of a novel medication scanner on administration errors in the hospital setting: a before and after feasibility study

Discrepancies between medication orders and infusion pump programming in a paediatric intensive care unit.

Building consensus about eHealth in Slovene primary health care: Delphi study

The Impact of Technology on Prescribing Errors in Pediatric Intensive Care: A Before and After Study

Has information technology finally been adopted in Flemish intensive care units?

AMDIS Case Conference: Intrusive Medication Safety Alerts.

Defining electronic-prescribing and infusion-related medication errors in paediatric intensive care – a Delphi study