Assuring Medication Safety in K-12 Schools: Implementing and Evaluating the Electronic School Medication Administration Record (E-SMAR) System

确保 K-12 学校的用药安全：实施和评估电子学校用药管理记录 (E-SMAR) 系统

• 批准号: 10628674
• 负责人: Amany Farag
• 金额: $ 33.02万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10628674
• 关键词: Assuring; Medication; Safety; 12; Schools

Approximately 27% of the 52 million K-12 school-age children (5-18 years) in the United States experience at least one chronic medical condition (CCMC) requiring them to receive medication during the school day. Adherence to the medications and their scheduled dosing is crucial for the CCMC’s health and academic progress. However, primary schools are an understudied community healthcare setting with school nurses (SNs) as the main healthcare provider. Widespread budgetary cuts have left 18% of schools across the nation with no designated SN,2,6 leaving the vast majority (78%) of medication administrations to unlicensed assistive personnel (UAP). Because these individuals are not healthcare providers, medication errors are three times higher when administered by UAP than by a SN. To reduce medication errors in schools, we propose a technology-assisted system to help SNs and UAP with medication administration and documentation. Our proposed computer-based system, the Electronic School Medication Administration Record (eSMAR). Our system prototype was tried in simulated environment. Therefore, the purpose of this demonstration project is to implement eSMAR in a real-world setting (grade schools) and to evaluate the usability and effectiveness of eSMAR on medication administration and documentation in schools. Aim 1: Implement and evaluate the usability of eSMAR in a select sample of K-12 schools in the Iowa City Community School District (ICCSD). We will achieve this aim by analyzing data from a) usability surveys from SNs and UAP, b) eSMAR system usage reports, c) observation, filed notes, and semi-structured interviews during site visits, and c) parent satisfaction survey. Aim 2: Understand contextual factors influencing eSMAR implementation. We will achieve this aim by conducting site visits using rapid ethnographic assessment (REA). Consolidated Framework for Implementation Research (CFIR) and EPIS domains will inform the development of the REA measures. Data from Aims 1&2 will be triangulated to deepen our understanding of contextual variables influencing eSMAR implementation. Aim 3: Evaluate the effectiveness of eSMAR (number of errors intercepted). We will achieve this aim by analyzing data from the eSMAR reports for the number, type, and frequency of errors intercepted by eSMAR. We will compare data on users (SNs vs. UAP), type of medication, time, medical condition, child’s age and grade level. Data from ICCSD incident reports will be collected to identify types of errors not prevented by the eSMAR system.

美国5200万K-12学龄儿童（5-18岁）中约有27% 国家经历至少一种慢性疾病（CCMC），需要他们接受 上学期间服药。坚持药物治疗及其计划给药是 这对CCMC的健康和学术进步至关重要。然而，小学是一个 以学校护士（SN）为主要医疗保健的社区医疗保健环境 提供商广泛的预算削减使全国18%的学校没有 指定SN，2，6，使绝大多数（78%）药物给药无证 辅助人员（UAP）。因为这些人不是医疗保健提供者， 由UAP管理时的错误是由SN管理时的三倍。以降低用药 错误，我们提出了一个技术辅助系统，以帮助SN和UAP 药物管理和记录。我们建议的电脑系统， 电子学校药物管理记录（eSMAR）。我们的系统原型 在模拟环境中。因此，该示范项目的目的是实施 eSMAR在现实世界中的设置（小学），并评估的可用性和有效性 学校药物管理和记录的eSMAR。 目标1：在选定的K-12学校样本中实施和评估eSMAR的可用性 在爱荷华州市社区学区（ICCSD）。 我们将通过分析a）SN和UAP的可用性调查数据，B） eSMAR系统使用报告，c）观察，归档笔记，以及半结构化访谈 （c）家长满意度调查。 目标2：了解影响eSMAR实施的环境因素。 我们将通过使用快速人种学评估（REA）进行现场访问来实现这一目标。 实施研究综合框架（CFIR）和EPIS领域将为 制定REA措施。目标1和2的数据将进行三角测量，以加深我们的 理解影响eSMAR实施的环境变量。 目标3：评估eSMAR的有效性（截获的错误数量）。 我们将通过分析eSMAR报告中的数据来实现这一目标， eSMAR截获的错误频率。我们将比较用户数据（SN与UAP）、类型 药物，时间，医疗条件，孩子的年龄和年级。ICCSD事故数据 将收集报告，以确定eSMAR系统无法防止的错误类型。