Electronic prescribing and medicines administration (EPMA) could reduce the likelihood of a small number of low-harm and moderate-harm medication-related incidents, according to a team from the University of Nottingham and Nottingham University Hospital NHS Trust, UK.
By analysing the frequency of the different types of medication-related incidents that caused patient harm, the researchers found that more than half of the incidents (n=243, 62.8%) could not be mitigated by any use of EPMA, even with further development, but EPMA could reduce the likelihood of a small number of the least harmful incidents.
The research team, which included hospital pharmacy and medical staff, conducted a retrospective review of harmful incidents (n=387) for medication-related reports at a major UK teaching hospital between September 2020 and August 2021 and the frequency of different types of incidents were collated. DATIX reports and investigation results were reviewed to determine whether EPMA could have prevented the harmful incidents.
Administration errors were found to cause the largest proportion of harmful medication incidents (n=215, 55.6%), followed by incidents classified as ‘other’ (n=102, 26.4%) and ‘prescribing’ (n=46, 11.9%). The majority of incidents were classified as ‘low harm’ (n=321, 83.0%).
Reducing errors with EPMA
EPMA would not have been able to reduce the likelihood of the incident in 62.8% of all incidents where harm was identified due to issues where the software has no impact such as lack of communication, distractions or staff shortages.
However, the researchers found that implementation of EPMA could potentially reduce the likelihood of all incidents which caused harm by 18.6% (n=72) without any software configuration, and by an additional 7.5% (n=29) if configurations were made.
For the low harm incidents (n=59) and moderate harm incidents (n=13), EPMA could reduce the incident likelihood by 18.4% and 20.3% respectively without configuration.
EPMA also has the potential to reduce medication errors caused by illegibility, multiple drug charts or missing drug charts, the researchers said.
The study shows that EPMA can lead to a reduction of harmful incidents in hospitals, particularly with targeted configuration and development of software and the researchers suggest the findings can be used by hospitals to optimise their EPMA systems.
Reference
Cattell M et al. Retrospective review of medication-related incidents at a major teaching hospital and the potential mitigation of these incidents with electronic prescribing and medicines administration. European Journal of Hospital Pharmacy 2024; Jun 21: doi.org/10.1136/ejhpharm-2022-003515.
