Development and application of a closed-loop medication administration system in University of Hongkong-Shenzhen Hospital

摘要

Objective: This study aimed to develop and apply a closed-loop medication administration system in a hospital in order to reduce medication administration errors(MAEs).Methods: The study was implemented in four pilot general wards. We used a before-and-after design to collect oral medication administration times before and after the implementation of the closed-loop medication administration system, evaluated MAE alert logs after the intervention, and conducted a survey of the nurses' satisfaction with the system in the pilot wards.Results:(a) Nursing time of oral medication administration: before the adoption of the closed-loop medication administration system,the average nursing time was 31.56 ± 10.88 minutes(n = 78); after the adoption of the system, the time was 18.74 ± 5.60 minutes(n = 54). Independent sample t-tests showed a significant difference between two groups(t= 8.85, P <0.00).(b) Degree of nurses' satisfaction with the closed-loop medication administration system: 60.00%(n = 42) of nurses considered the system to be helpful for their work and nearly half of the nurses(47.14%, n = 33) believed that the system could facilitate clinical work and reduce workload;51.43%(n = 36) believed that the system could reduce checking time and enhance work efficiency; 82.86%(n = 58) believed that the system was helpful in improving checking accuracy to reduce MAEs and ensure patient safety. More than 60% of the nurses considered the system to be a method that could help to track MAEs to improve nursing quality.(c) The MAE alert logs during observation period:it revealed only 27 alerts from the repeated scans of 3,428 instances of medication administration.Conclusions: The nurses were satisfied with the closed-loop medication administration system because it improved their work efficiency and reduced their workload. The current investigation was limited by time; therefore, further research is needed to more closely examine the relationship between the system and MAEs.