Assignment 2: Is Your Process Following Your Policy?

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

Medication errors are among the most significant cause of patient injury in all types of medical errors (Johnson, Carlson, Tucker, & Willette, n.d). In the nursing profession, medication administration errors occur 34% of the time, second only to physician ordering errors (Gooder, 2011). The introduction of information technology, such as the Bar Code Medication Administration (BCMA), offers new opportunities for reducing medication administration errors. BCMA was developed by the Veteran’s Affairs Medical Center in 1998 to help improve the documentation of medication administration, decrease medication errors and provide

E prescribing can be a part of the EHR in Epic, which would include patient data, and not just prescription information. When e prescriptions are utilized in Epic, the medication is checked for interactions with the patient’s other medications and allergies. Check systems within Epic look for drug-allergy, drug-drug, and how the medication reacts with the disease. In a case study of 17 physicians in an ambulatory clinic conducted by Abramson et al., error rates from prescribing decreased from 35.7 per 100 prescriptions to 12.2 per 100 prescriptions in a year of e-prescribing as reviewed in this study. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 stated that healthcare providers would have access to EHRs to ensure the meaningful use standards per the Centers for Medicaid and Medicare Services (CMS). Meaningful use is attained by increasing the quality of patient outcomes by having access to the medication data, the patient’s history, and diagnosis by the prescriber. Prescribing is safer, when the provider is aware of the patient’s history, current medications, and allergies, therefore better patient outcomes. In the United States, the HITECH Act and the meaningful use standards stated by CMS have increased the use of e-prescribing per Friedman (2009). The CMS made e prescribing a

This integrative review sought to identify and understand the impact of information technology in on medication errors. The review of 14 papers shows that the implementation of medication management systems, which include CPOE, BCMA and automated dispensing machines has successfully reduced medication errors and adverse medication events significantly, particularly the two most susceptible stages of prescription and administration of drugs (Armada et al., 2014).

Bar code medication administration (BCMA) is a mechanism to decrease medication mistakes through scanning a code printed on the patient’s armband and then scanning the medication (Leapfrog Hospital Survey, 2016). The scanned information is processed through the electronic medical record and displays on the medication administration record (MAR) to ensure that bedside nurses are using the “Five Rights of Medication Administration” (Leapfrog Hospital Survey, 2016). The process of passing medication to patients has moved from a printed medication administration records and medication carts to an electronic version with automated medication dispensing systems. This electronic version effects nursing care by

Medication history is nothing more than a detailed, accurate and complete account of all prescribed and non-prescribed medications a patient might have taken or is presently taking upon to the arrival to the acute care institution. One of the challenges in the process of completing the medication history, is the ability to obtain pertinent and valuable information in a timely manner as this provides valuable insight in guiding appropriate treatment and care during the emergency situation. Doing so in an effective manner can help prevent medication errors and consequent risks to patients. Another challenge is the lack of technology integration across the national healthcare system which poses significant difficulties in obtaining accurate information from a variety of sources in a timely manner. Regulatory and accreditation bodies have made it a requirement that healthcare systems focus on improving the medication reconciliation across the continuum of

The second study focused on a patient care unit, which include 2 medical-surgical units, 2 telemetry units, 2 rehabilitation units, and a medical-surgical intensive care unit, and Oncology unit (Seibert et al., 2014). This is a pre and posttest non-equivalent comparison group study that focused on the medication administration accuracy error rates at a community based hospital. The units were observed and recorded at one month, six months, and 12 months after the electronic barcode medication administration system as implemented. According to Seibert et al., 2014), medication catastrophes attribute to errors in medication administration ranges from 2.4% to 1.1%, and can elevate to 34-49%. Although direct observation is a “standard” tool used in identifying medication errors, other modality such as computerized monitoring, chart reviews is also utilized (Seibert et al., 2014).

An accurate list of all medications will be produced. An up to date list of all medical providers and their contact information, including the name and number of the patient’s local pharmacy will be created with the patient and his spouse. The patient will be encouraged to use only one pharmacy, and to bring all medications to visits with his providers (Woodruff, 2010).

In the United States, Nearly 1 of each 131 out- patient mortalities and 1 of 853 inpatient mortality consequence after medication mistakes. Baxter International stated 39% of mistakes start among prescribers, 23% happen while copying or mixing by pharmacists, and 38% transpire while the administration through nurses (Caesar, & Hutchinson, 2006). According to the Institute of Medicine approximations that at about a fourth of every medication-related inquiry remain avoidable, and endorses electronic prescribing (e-prescribing) through a computerized provider order entry(CPOE) system by way of single method to decrease prescription mistakes. The questions developed as For adult inpatients (P), would the use of (I) physician order entry within an Electronic Health Record, (C) as compared to solely paper documentation, (O) result in a medication error rate reduction similar to that found in the literature (T) during the length of stay the hospital?

Most facilities that deal with patient care in this day and age have implemented some form of electronic health records to store patient health care related information. Pharmacies that have an electronic patient record system in place help to improve patient care coordination by reducing errors, enhancing patient privacy and ensuring data is accessible. Information Security ensures that medication, funds and patient data are protected to encourage quality service, positive brand recognition and overall success of any pharmacy. In order to provide this level of service to patients, a well planned and executed security plan that incorporates the access control procedures and policies must be created. This plan will have to encompass hours of operation, opening and closing store front procedures, for logical and physical access control accountability, combinations creation and maintenance, record of keys made and who should be able to access any area in particular, authorized accesses control for building, computer, electric, water and ground maintenance, transportation and transfer of drugs, procedures for reporting in any type of losses and replacement procedures for any device that can grant access within the

Hospitals with automated centralized pharmacies reported that greater than 50% of their inpatient doses were dispensed via centralized automated systems. Half of all responding hospitals used a decentralized medication storage system. One-third of hospitals with automated storage and dispensing systems were linked to the pharmacy computer. Importantly, about half of the surveyed hospitals reported drug distributions that bypassed the pharmacy including floor stock, borrowing patients’ medications, and hidden drug supplies. Study Designs There were no true randomized trials. One crossover study of the McLaughlin dispensing system randomized nurses to work with the intervention medication system or the control 112 •

Bates and Gawande, in their article, Improving Safety with Information Technology, notes that medication interactions are now accurately check by computers, thus saving patients from potentially harmful interactions. In the past nurses were requires to calculate infusion rates

Another element implemented into the pharmacy was the use of the electronic medical record system, which provided access to the patients’ medical history and physician collaboration. The different method implemented in the work setting

Pharmacists have implemented systems to attempt to cut back on mishaps but they are still very prevalent in the field. The implementation of computers into pharmacy has lessened human error because it breaks down complex processes, allowing the worker to concentrate on one task at a time.

First, computer databases for data about pharmaceuticals, and therapeutic treatment all in all, are utilized inside of drug stores. These database frameworks permit pharmacy staff to discover data about any potential clashes or human services issues in an endorsed treatment, and data about the points of interest of any specific prescription the pharmacist needs to know more about. This data may incorporate fixings and potential impacts and also examine and find information.