Dose Verification Errors in Hospitals: Literature Review of the eMAR-based Systems Used by Nurses.

BACKGROUND: The effectiveness of the dose verification features of the electronic medication administration record (eMAR) and complementary systems in the hospital setting is not well understood. PURPOSE: The authors completed a narrative synthesis of literature findings on the effectiveness of eMAR-based systems in the hospital setting. METHODS: A literature review was carried out across 5 bibliographic databases to evaluate the safety features of current eMAR-based systems in preventing dosing errors and design issues that impede their usability. RESULTS: While eMAR-based systems are beneficial to reducing order and drug cross-checking errors, safe dose verification features are sporadically available for targeted tasks. Overall, the eMAR had little impact on preventing low to moderate dosing errors. Dosing errors may occur because of error-prone activities that result from system design and work process issues during medication administration.

A comparison of clinicians' access to online knowledge resources using two types of information retrieval applications in an academic hospital setting.

OBJECTIVE: The research studied whether a clinician's preference for online health knowledge resources varied with the use of two applications that were designed for information retrieval in an academic hospital setting. METHODS: The researchers analyzed a year's worth of computer log files to study differences in the ways that four clinician groups (attending physicians, housestaff physicians, nurse practitioners, and nurses) sought information using two types of information retrieval applications (health resource links or Infobutton icons) across nine resources while they reviewed patients' laboratory results. RESULTS: From a set of 14,979 observations, the authors found statistically significant differences among the 4 clinician groups for accessing resources using the health resources application (P<0.001) but not for the Infobuttons application (P = 0.31). For the health resources application, the preferences of the 4 clinical groups varied according to the specific resources examined (all P≤0.02). CONCLUSION: The information-seeking behavior of clinicians may vary in relation to their role and the way in which the information is presented. Studying these behaviors can provide valuable insights to those tasked with maintaining information retrieval systems' links to appropriate online knowledge resources.

An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals.

In healthcare, patient handoffs are a common practice that is implemented by most clinicians who carry the responsibility of patient care. Ineffective handoffs have been associated with the occurrence of adverse clinical events. With the inception of the Joint Commissions' National Patient Safety Goal (NSPG) 2E on handoff communication, computerized clinical handoff applications are emerging in hospitals. Computerized clinical handoff applications are intended to assist the clinicians in conducting effective handoffs by providing easy access to accurate clinical information and reducing the burden of handoff report upkeep. The purpose of this paper is to identify various types of computerized clinical handoff tools that are used in hospitals and perform a comparison of application characteristics, review clinical and business advantages and disadvantages in implementing computerized clinical handoff applications, and give recommendations for improvement.