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：申请人的逐字记录？的抽象 这项研究的目的是确定使用个人 数字助理（PDA）的处方对潜在的用药错误， 初级保健医生办公室为基础的做法。具体目标是 研究的目的是：1）测量潜在可预防药物的发生率 在医生办公室为基础的做法相关的错误; 2）评估医生？ 对PDA的态度，以确定与使用频率相关的问题， 易于应用于临床情况，并对信息充满信心 从与药物相关的手持计算机应用程序中获得; 3） 确定医学博士认为PDA在实践中使用的障碍， 克服这些障碍的战略; 4）确定 医生可以降低潜在用药相关错误的频率 改善了对药物信息的获取， 通过使用个人数字助理设备（PDA）进行护理;以及5） 确定潜在药物相关频率的程度 医生使用PDA作为处方打印可以减少错误 在办公室的实践中。主要项目是一个前瞻性的， 在40个初级保健办公室的40名医生中进行的随机对照试验 观察PDA使用对潜在处方药影响的实践 错误.每名医生的基线潜在用药错误率为 对所有医生来说都是如此。然后将医生随机分为两组 实验分为两组：干预组和对照组。干预涉及 培训医生在治疗期间使用临床信息应用程序， 通过PDA处方流程，输入并打印 通过PDA将处方发送到本地打印机。对照组将进行 他们的传统处方实践。之前 介绍干预措施，分析人为因素， 医生现场的环境驱动因素？办公室将进行， 确定技术障碍，克服这些障碍的战略， 以及将该技术及其应用最佳地纳入 办公环境。教学设计方法将用于准备一个 以实践为基础的课程，使用案例模拟来教授医生 干预组中的处方者如何参与并系统地使用 这个过程对它们的预期使用频率进行基线评估， 易于应用于临床情况，并对信息充满信心 将对获得的结果进行研究。使用后，这些措施将重复使用 调查工具和深入访谈。之间的差异 对照组和干预组每名医生的平均潜在错误率为 测定双变量非参数统计将用于评估 医生对PDA使用的看法发生变化， 干预预期成果是：1）改善提供者教育， 减少错误，2）将行之有效的IT战略转化为广泛的 （3）提高能力，进一步减少错误。该项目将 产生可供提供者、患者、付款人使用的新知识， 决策者确定手持PDA对减少医疗费用的贡献， 错误和改善病人的安全，在初级保健医生办公室为基础的 实践环境。