Automated drug dispensing system reduces medication errors in an intensive care setting
Claire Chapuis
(1)
,
Matthieu Roustit
(2)
,
Gaëlle Bal
(3)
,
Carole Schwebel
(4)
,
Pascal Pansu
(5)
,
Sandra David-Tchouda
(6)
,
Luc Foroni
(4)
,
Jean Calop
(7)
,
Jean-Francois Timsit
(8)
,
Benoit Allenet
(9)
,
Jean-Luc Bosson
(10)
,
Pierrick Bedouch
(9)
1
UGA UFRP -
Université Grenoble Alpes - UFR Pharmacie
2 CIC - Grenoble
3 UGA UFRM - Université Grenoble Alpes - UFR Médecine
4 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
5 LSE - Laboratoire des Sciences de l'Éducation (Grenoble)
6 CIC-IT Grenoble (CIT803) - Centre d'Investigation Clinique - Innovation Technologique - INSERM - CHU de Grenoble
7 CHU de Grenoble - Centre Hospitalo-Universitaire de Grenoble
8 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
9 TIMC-IMAG-ThEMAS - Techniques pour l'Evaluation et la Modélisation des Actions de la Santé
10 TIMB
2 CIC - Grenoble
3 UGA UFRM - Université Grenoble Alpes - UFR Médecine
4 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
5 LSE - Laboratoire des Sciences de l'Éducation (Grenoble)
6 CIC-IT Grenoble (CIT803) - Centre d'Investigation Clinique - Innovation Technologique - INSERM - CHU de Grenoble
7 CHU de Grenoble - Centre Hospitalo-Universitaire de Grenoble
8 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
9 TIMC-IMAG-ThEMAS - Techniques pour l'Evaluation et la Modélisation des Actions de la Santé
10 TIMB
Pascal Pansu
- Fonction : Auteur
- PersonId : 1165278
- IdHAL : pascal-pansu
- ORCID : 0000-0002-8344-615X
Sandra David-Tchouda
- Fonction : Auteur
- PersonId : 959363
Benoit Allenet
- Fonction : Auteur
- PersonId : 949812
Pierrick Bedouch
- Fonction : Auteur
- PersonId : 859134
Résumé
OBJECTIVES:
We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction.
DESIGN:
Preintervention and postintervention study involving a control and an intervention medical intensive care unit.
SETTING:
Two medical intensive care units in the same department of a 2,000-bed university hospital.
PATIENTS:
Adult medical intensive care patients.
INTERVENTIONS:
After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control.
MEASUREMENTS AND MAIN RESULTS:
The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; p<.05); however, no significant difference was observed before automated dispensing system implementation (20.4% and 19.3%, respectively; not significant). Before-and-after comparisons in the study unit also showed a significantly reduced percentage of total opportunities for error (20.4% and 13.5%; p<.01). An analysis of detailed opportunities for error showed a significant impact of the automated dispensing system in reducing preparation errors (p<.05). Most errors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale.
CONCLUSIONS:
The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.
Domaines
Sciences de l'Homme et SociétéFormat du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
Automated drug dispensing system reduces medication errors in an intensive care setting
|
Résumé |
en
OBJECTIVES:
We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction.
DESIGN:
Preintervention and postintervention study involving a control and an intervention medical intensive care unit.
SETTING:
Two medical intensive care units in the same department of a 2,000-bed university hospital.
PATIENTS:
Adult medical intensive care patients.
INTERVENTIONS:
After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control.
MEASUREMENTS AND MAIN RESULTS:
The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; p<.05); however, no significant difference was observed before automated dispensing system implementation (20.4% and 19.3%, respectively; not significant). Before-and-after comparisons in the study unit also showed a significantly reduced percentage of total opportunities for error (20.4% and 13.5%; p<.01). An analysis of detailed opportunities for error showed a significant impact of the automated dispensing system in reducing preparation errors (p<.05). Most errors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale.
CONCLUSIONS:
The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.
|
Auteur(s) |
Claire Chapuis
1
, Matthieu Roustit
2
, Gaëlle Bal
3
, Carole Schwebel
4
, Pascal Pansu
5
, Sandra David-Tchouda
6
, Luc Foroni
4
, Jean Calop
7
, Jean-Francois Timsit
8
, Benoit Allenet
9
, Jean-Luc Bosson
10
, Pierrick Bedouch
9
1
UGA UFRP -
Université Grenoble Alpes - UFR Pharmacie
( 144104 )
- Domaine de la Merci - 38706 La Tronche cedex
- France
2
CIC - Grenoble
( 2603 )
- Centre Hospitalier Universitaire LYON 38043 GRENOBLE CEDEX 9
- France
3
UGA UFRM -
Université Grenoble Alpes - UFR Médecine
( 97332 )
- Domaine de la Merci - 38706 La Tronche cedex
- France
4
CHUGA -
Centre Hospitalier Universitaire [CHU Grenoble]
( 257328 )
- CS 10217
38043 Grenoble cedex 9
- France
5
LSE -
Laboratoire des Sciences de l'Éducation (Grenoble)
( 123645 )
- UFR SHS - BSHM - 1251 avenue Centrale - Domaine Universitaire - 38400 Saint-Martin d'Hères
- France
6
CIC-IT Grenoble (CIT803) -
Centre d'Investigation Clinique - Innovation Technologique - INSERM - CHU de Grenoble
( 235012 )
- Centre d'Investigation Clinique - Innovation Technologique, Institut d'Ingénierie de l'Information de Santé - Pavillon Taillefer - Faculté de Médecine - 38706 La Tronche cedex - France
- France
7
CHU de Grenoble -
Centre Hospitalo-Universitaire de Grenoble
( 209819 )
- Service pharmaceutique Centre Hospitalo-Universitaire de Grenoble BP 217 38043 Grenoble
- France
8
IAME (UMR_S_1137 / U1137) -
Infection, Anti-microbiens, Modélisation, Evolution
( 247341 )
- Faculté de médecine Paris Diderot Paris 7 - site Bichat - 16 rue Henri Huchard 75890 Paris Cedex 18
- France
9
TIMC-IMAG-ThEMAS -
Techniques pour l'Evaluation et la Modélisation des Actions de la Santé
( 388317 )
- Domaine de la Merci, 38706 La Tronche
- France
10
TIMB
( 391517 )
-
- France
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2010
|
Volume |
38
|
Numéro |
12
|
Page/Identifiant |
2275 - 2281
|
Domaine(s) |
|
DOI | 10.1097/CCM.0b013e3181f8569b |
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