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Detection and prevention of medication errors using real-time bedside nurse charting.

Nancy C Nelson1, R Scott Evans, Matthew H Samore

  • 1Department of Medical Informatics, LDS Hospital, Salt Lake City, UT 84143, USA. ldnnelso@ihc.com

Journal of the American Medical Informatics Association : JAMIA
|April 2, 2005
PubMed
Summary

Implementing real-time bedside charting for nurses significantly improves medication safety. Educational interventions and feedback enhance the use of computerized charting systems, reducing potential errors.

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Area of Science:

  • Healthcare Informatics
  • Patient Safety
  • Nursing Practice

Background:

  • Computerized charting systems with decision support are intended to reduce medication errors.
  • Analysis of medication error reports indicated underutilization of these systems' decision support features.
  • A key factor for effective decision support is real-time entry at the patient's bedside.

Purpose of the Study:

  • To increase real-time bedside charting behavior among nurses.
  • To improve the utilization of computerized medication charting systems.
  • To enhance medication error prevention through improved charting practices.

Main Methods:

  • A quasiexperimental before-and-after study design was employed.
  • Two surgical units were utilized: one as a study unit, the other as a control.

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  • The study unit received a 12-week educational intervention focused on error avoidance via real-time bedside charting, coupled with performance feedback.

    • Main Results:

    • On the study unit, real-time charting increased from 59% to 73%, and bedside charting from 40% to 63% post-intervention.
    • Sustained improvements were observed, with real-time rates reaching 75% after eight weeks and remaining stable at one year.
    • Control unit rates showed minimal variation, with real-time charting between 53-57% and bedside charting between 34-44%.

    Conclusions:

    • Targeted educational interventions and consistent performance monitoring demonstrably improve the effective use of computerized medication charting systems.
    • These improvements in charting practices are crucial for enhancing medication safety and error reduction.
    • Continuous educational efforts and feedback are necessary to maintain and further optimize system utilization.