Evaluation of electronic medication management systems on inpatient
omitted dose rates at 2 acute metropolitan hospitals
Abstract
Rationale, aim and objectives: Medication error is common and the most
common form of administration error is omission. Implementation of
Electronic Medication Management systems (eMMS) has been hypothesized to
decrease the rate of omitted doses due to the creation of a number of
forcing functions and decision support tools however there is limited
evidence currently available in the literature to support this
assumption. This study therefore aims to ascertain if implementation of
eMMS at 2 acute metropolitan hospitals reduces the rate of omitted doses
Method: A retrospective cohort study was undertaken pre and post
implementation of eMMS. Patients meeting eligibility criteria had all
medication charts from their admission reviewed and an omitted dose rate
calculated. For each omitted dose identified; medication name, imprest
availability, dispensing history, administration time and frequency were
recorded. Results: 386 patients met eligibility criteria for this study
(11,796 opportunities for omission). The implementation of eMMS was
associated with a significant reduction in omitted doses (3.6% vs 1.8%
p<0.01). Benefit was not consistent among subgroups. eMMS
implementation at the hospital with the higher baseline omitted dose
rate was associated with a significant reduction in omitted doses (5.8%
vs 0.9% p<0.01) but not at the hospital with a lower baseline
rate (2.7% vs 2.4% p=0.3). The most common times for an omitted dose
to occur were 0800 (33%) and 2000 (18%). The most common frequencies
for an omitted dose were daily (35%) and twice daily (32%).
Conclusion: The introduction of eMMS was associated with a decrease rate
of omitted doses. Greatest benefit is likely to occur in areas with a
high baseline rate of omission.