The impact of electronic medication administration records (e-MAR) on medication administration safety and nurses' work

对国家和国际卫生系统的需求日益增长，而人口老龄化和卫生工作人员短缺又加剧了这一需求。将信息技术纳入新的医疗保健提供模式，有望提高医疗服务的安全性和效率。用药错误是医疗保健系统最重要的安全问题之一。药物管理占用了大量的护士的时间，也充满了错误的可能性。在所有导致患者伤害的用药错误中，有三分之一来自给药错误（MAE）。电子给药记录（e-MAR）通过降低错误率以及允许护士更有效地管理药物任务，为患者提供了更安全的给药可能性。然而，来自澳大利亚或海外的研究非常有限，这些研究考察了他们是否将系统计算机化，实际上是否降低了错误率或节省了护士的时间。在本项目中，我们将进行前瞻性对照观察性研究，以确定电子给药记录（e-MAR）的有效性，以减少MAE和护士在给药过程中花费的时间。该项目将采用创新的数据收集工具，使用专门为这些研究设计的PDA软件，这些研究已经在临床环境中进行了广泛的试点测试。研究结果将对澳大利亚和国际上的医院在考虑实施e-MAR时产生重要影响。这项研究将提供澳大利亚首次全面的用药错误数据，以评估未来的预防性错误策略。研究结果将为如何减少MAE和改进e-MAR的设计提供必要的证据。

The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.