Personal digital assistant devices and medication error

个人数字助理设备和用药错误

• 批准号: 6528318
• 负责人: KIMBERLY A GALT
• 金额: $ 33.57万
• 依托单位: CREIGHTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2004-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6528318
• 关键词: clinical research; clinical trials; computer human interaction; health care personnel performance; health service demonstration project; human subject; patient safety /medical error; personal computers; primary care physician

DESCRIPTION: Verbatim from the Applicant?s Abstract The purpose of this study is to determine the impact of the use of personal digital assistants (PDAs) by prescribers on potential medication errors in primary care physicians office-based practices. The specific aims of this study are to: 1) measure the occurrence of potential preventable medication related errors in physician office-based practices; 2) assess physicians? attitudes toward the PDAs to determine issues related to frequency of use, ease of application to clinical situations, and confidence in the information obtained from the handheld computer applications related to medications; 3) identify barriers perceived by M.D.s to PDA use in practice and successful strategies to overcome these barriers; 4) determine the extent to which the frequency of potential medication related errors may be reduced by physicians having improved access to pharmaceutical information needed at the point of care through the use of personal digital assistant devices (PDAs); and 5) determine the extent to which the frequency of potential medication related errors may be reduced by physicians using the PDA as a prescription printing device in office-based practice. The primary project is a prospective, randomized, controlled trial of 40 physicians in 40 primary care office-based practices to observe the impact of PDA use on potential prescriber medication errors. A baseline potential medication error rate per physician will be determined for all physicians. The physicians will then be randomized to two groups: an intervention group and a control group. The intervention involves training the physicians to use clinical information applications during the prescribing process through the PDA and entering and printing the prescriptions to a local printer via the PDA. The control group will conduct their traditional prescribing practices throughout the study. Prior to introducing the intervention, an analysis of the human factors and environmental drivers on site in the physicians? offices will be conducted to identify barriers to the technology, strategies to overcome these barriers, and optimal incorporation of the technology and its applications into the office environment. Instructional design methods will be used to prepare a practice-based curriculum using case-simulation to teach the physician prescribers in the intervention group how to engage in and systematically use this process. A baseline assessment of their anticipated frequency of use, ease of applications to clinical situations, and confidence in information obtained will be studied. After use, these measures will be repeated by use of survey instruments and in-depth interviews. The difference between the control and intervention group mean potential error rate per physician will be determined. Bivariate nonparametric statistics will be used to assess the change in perception of the physicians regarding PDA use as a result of the intervention. Expected outcomes are 1) to improve provider education to reduce errors, 2) translate proven effective IT strategies into widespread practice, and 3) build capacity to further reduce errors. This project will generate new knowledge that can be used by providers, patients, payers, and policymakers to determine the contribution of handheld PDAs to reduce medical errors and improve patient safety in the primary care physician office-based practice environment.

描述：申请人逐字摘录？S摘要 这项研究的目的是确定个人使用的影响 数字助理(PDA)由处方人员针对潜在的用药错误 初级保健医生办公室执业。这样做的具体目的是 研究的目的是：1)衡量潜在的可预防药物的发生率 医生办公室执业中的相关错误；2)评估医生？ 对掌上电脑的态度，以确定与使用频率有关的问题， 易于应用于临床情况，并对信息有信心 从与药物有关的手持计算机应用程序获得；3) 确定医学博士在实践中和成功使用PDA时所感受到的障碍 克服这些障碍的战略；4)确定在多大程度上 医生可能会减少潜在的用药相关错误的频率 改进了对药物信息的访问， 通过使用个人数字助理设备(PDA)进行护理；以及5) 确定潜在用药的频率与 医生可以通过使用PDA作为处方打印来减少错误 基于办公室的实践中的设备。主要的项目是一个前瞻性的， 对40名初级保健办公室的40名医生进行的随机对照试验 观察PDA使用对潜在处方者用药影响的实践 错误。每位医生的基准潜在用药错误率将为 为所有内科医生下定决心。然后，医生将被随机分配到两名 分组：干预组和对照组。这项干预包括 培训医生在培训期间使用临床信息应用程序 通过掌上电脑开具处方流程并录入和打印 通过PDA将处方发送到本地打印机。对照组将进行 在整个研究过程中，他们的传统处方做法。在.之前 介绍了干预措施，分析了人为因素和 环保司机在医生的现场？办事处将被安排到 确定技术障碍、克服这些障碍的策略、 并将该技术及其应用最佳地结合到 办公环境。将使用教学设计方法准备一份 以实践为基础的课程--运用案例模拟教学 干预组处方人员如何参与和系统使用 这一过程。对其预期使用频率的基线评估， 临床应用的简便性和对信息的信心 将对所获得的信息进行研究。使用后，这些措施将重复使用 调查工具和深入访谈。两者之间的区别 控制组和干预组每个医生的平均潜在错误率将是 下定决心。将使用双变量非参数统计量来评估 医生对PDA使用的看法的变化 干预。预期结果是1)改善提供者教育，以 减少错误，2)将久经考验的有效IT战略转化为广泛的 实践，以及3)建设能力，以进一步减少错误。这个项目将 生成可供提供者、患者、付款人和 政策制定者将确定手持PDA对减少医疗费用的贡献 以初级保健医生办公室为基础的错误和改善患者安全 练习环境。