Effect of Real-time Clinical Monitoring and a 'Closed Loop' Medication System on Adverse Drug Event Detection; Final rept. 21 Sep 2006-20 Mar 2008

摘要

Holy Name Hospital has undertaken a comprehensive redesign of medication management system including the introduction of pharmacy robotics; computerization of all phases of medication management including inventory, order entry with decision support, and electronic medication administration record; as well as beside bar code scanning of patient, staff and medications. The implementation of this comprehensive redesign has allowed us to conduct research to determine whether decision support will foster a reduction in adverse drug events. We have selected 5 commonly prescribed medications that are associated with well-known adverse events that manifest as laboratory abnormalities. The use of an electronic medication administration record which incorporates bar-code scanning at the bedside allows for display of pertinent laboratory results in real time during medication administration. Review of such results provides decision support that allows for dose adjustment or discontinuation in the face of adverse laboratory trends. Our project involves studying data for 6 months of medication administration prior to the introduction of pertinent laboratory display and comparing it to 6 months of data after pertinent lab studies were available for review at the time of administration. We will examine the frequency and severity of adverse drug events in this context.