scholarly journals The impact of an electronic prescribing and administration system on the safety and quality of medication administration

2008 ◽  
Vol 16 (6) ◽  
pp. 375-379 ◽  
Author(s):  
Bryony Dean Franklin ◽  
Ann Jacklin ◽  
Nick Barber
Keyword(s):  
Medication Administration ◽  
Electronic Prescribing ◽  
Administration System ◽  
The Impact

scholarly journals A Longitudinal Assessment of the Quality of Insulin Prescribing with Different Prescribing Systems

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Amandeep Setra ◽  
Yogini Jani
Keyword(s):  
Care Setting ◽  
Electronic Prescribing ◽  
Longitudinal Assessment ◽  
Prescribing Practices ◽  
Record System ◽  
Audit Data ◽  
Core Components ◽  
Secondary Care Setting ◽  
The Impact

Accurate and complete prescriptions of insulin are crucial to prevent medication errors from occurring. Two core components for safe insulin prescriptions are the word ‘units’ being written in full for the dose, and clear documentation of the insulin device alongside the name. A retrospective review of annual audit data was conducted for insulin prescriptions to assess the impact of changes to the prescribing system within a secondary care setting, at five time points over a period of 7 years (2014 to 2020). The review points were based on when changes were made, from standardized paper charts with a dedicated section for insulin prescribing, to a standalone hospital wide electronic prescribing and medicines administration (ePMA) system, and finally an integrated electronic health record system (EHRS). The measured outcomes were compliance with recommended standards for documentation of ‘units’ in full, and inclusion of the insulin device as part of the prescription. Overall, an improvement was seen in both outcomes of interest. Device documentation improved incrementally with each system change—34% for paper charts, 23%–56% for standalone ePMA, and 100% for ePMA integrated within EHRS. Findings highlight that differences in ePMA systems may have varying impact on safe prescribing practices.

scholarly journals The association between the transfer of emergency department admitted patients to inpatient hallways and outcomes of oncology patients

2015 ◽  
Vol 4 (2) ◽  
pp. 1 ◽  
Author(s):  
Charles Lim ◽  
Matthew C. Cheung ◽  
Maureen E. Trudeau ◽  
Kevin R. Imrie ◽  
Ben De Mendonca ◽  
...  
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Flow ◽  
Vital Signs ◽  
Medication Administration ◽  
Oncology Patients ◽  
Flow Quality ◽  
Ed Crowding ◽  
The Impact

Objective: A protocol was implemented to ease Emergency Department (ED) crowding by moving suitable admitted patients into inpatient hallway beds (HALL) or off-service beds (OFF) when beds on an admitting service’s designated ward (ON) were not available. This study assessed the impact of hallway and off-service oncology admissions on ED patient flow, quality of care and patient satisfaction.Methods: Retrospective and prospective data were collected on patients admitted to the medical oncology service from Jan 1 to Dec 31, 2011. Data on clinician assessments and time performance measures were collected. Satisfaction surveys were prospectively administered to all patients. Results: Two hundred and ninty-seven patients (117 HALL, 90 OFF, 90 ON) were included in this study. There were no significant differences between groups for frequency of physician assessments, physical exam maneuvers at initial physician visit, time to complete vital signs or time to medication administration. The median (IQR) time spent admitted in the ED prior to departure from the ED was significantly longer for HALL patients (5.53 hrs [1.59-13.03 hrs]) compared to OFF patients (2.00 hrs [0.37-3.69 hrs]) and ON patients (2.18 hrs [0.15-5.57 hrs]) (p < .01). Similarly, the median (IQR) total ED length of stay was significantly longer for HALL patients (13.82 hrs [7.43-20.72 hrs]) compared to OFF patients (7.18 hrs [5.72-11.42 hrs]) and ON patients (9.34 hrs [5.43-14.06 hrs]) (p < .01). HALL patients gave significantly lower overall satisfaction scores with mean (SD) satisfaction scores for HALL, OFF and ON patients being 3.58 (1.20), 4.23 (0.58) and 4.29 (0.69) respectively (p < .01). Among HALL patients, 58% were not comfortable being transferred into the hallway and 4% discharged themselves against medical advice. Conclusions: The protocol for transferring ED admitted patients to inpatient hallway beds did not reduce ED length of stay for oncology patients. The timeliness and frequency of clinical assessments were not compromised; however, patient satisfaction was decreased.

scholarly journals The Impact of Electronic Prescribing on the Professionalization of Community Pharmacists: A Qualitative Study of Pharmacists’ Perception

2008 ◽  
Vol 11 (1) ◽  
pp. 131 ◽  
Author(s):  
Aude Motulsky ◽  
Nancy Winslade ◽  
Robyn Tamblyn ◽  
Claude Sicotte
Keyword(s):  
Information Technologies ◽  
Knowledge Integration ◽  
New Technology ◽  
Community Pharmacists ◽  
Pilot Project ◽  
Electronic Prescribing ◽  
Electronic Prescription ◽  
Available Information ◽  
The Impact

Purpose. To understand how the technology of electronic prescription (e Rx) can transform the community pharmacist’s role through its effects on professionalization. We define professionalization as a pharmaceutical practice centred on clinical activities and made possible by the establishment of professional pharmaceutical services. Methods. We asked 12 community pharmacists who had participated in an e Rx pilot project in the Canadian province of Quebec to fill out a qualitative survey on their experience. We then analyzed the pharmacists’ perceptions of this new technology using a conceptual framework based on the Davenport typology that presents an exhaustive list of mechanisms, specific to Information Technologies, and thus e-Rx, that can potentially modify information management process and then the role of pharmacists. Results. The pharmacists identified five main mechanisms by which e Rx could affect the professionalization of community pharmacists: analytical capabilities of the pharmacist and physician, dissemination of knowledge, integration of process tasks, process automation and elimination of intermediaries. These mechanisms can assist pharmacists in exercising their professional judgement by improving the quality of available information and facilitate the execution of prescriptions by improving the quality of orders. E Rx technology can also strengthen pharmacists’ credibility as medication specialists in the eyes of both patients and physicians. Thus, e Rx can become a collaborative technology to the extent that it improves collaboration between community pharmacists and prescribing physicians. However, the potential benefits of this technology would appear to depend on its characteristics and how prescribing physicians use it. Conclusions. E-Rx proposes ways of working and communicating that were previously unimaginable. These new possibilities pave the way for transformations that can significantly increase the professionalization of community pharmacists. The results of this study indicate that community pharmacists have a favourable opinion of e Rx, believing it can be an ally in their professionalization.

scholarly journals Principles of Construction and Prospects of Development of the Digital Public Administration system in Modern Russia

2020 ◽  
Vol 10 (3) ◽  
pp. 103-107
Author(s):  
A. V. Makoveychuk
Keyword(s):  
Public Administration ◽  
Municipal Government ◽  
Digital Transformation ◽  
Public Authorities ◽  
Administration System ◽  
Interagency Cooperation ◽  
Wide Range ◽  
The Impact ◽  
Goals And Objectives

This article discusses the principles of construction and prospects for the development of digital public administration in modern Russia, the goals and objectives pursued by public authorities in realizing this digital transformation of their performing functions, planned results and assessing the impact on the socio-economic development of the state. The urgency of the problem of developing mechanisms of digital public administration in Russia is due to the need to optimize and improve the quality of public administration through the implementation of new forms of interaction between citizens and government at various levels and on a wide range of issues. Possible options and directions for the implementation of new digital solutions in the system of regional and municipal government, including in the system of interagency cooperation and the formation of personnel reserves, are described.

scholarly journals The Instrumental and Ideological Politicisation of Senior Positions in Poland’s Civil Service and its Selected Consequences

2018 ◽  
Vol 11 (1) ◽  
pp. 63-89 ◽  
Author(s):  
Stanisław Mazur ◽  
Michał Możdżeń ◽  
Marek Oramus
Keyword(s):  
Public Administration ◽  
Civil Service ◽  
Relevant Literature ◽  
Civil Service Reform ◽  
Administration System ◽  
Political Ideas ◽  
Negative Effect ◽  
The Impact ◽  
Radical Reconstruction

AbstractThe article focuses on the problem of the civil service’s dependence on its political superiors in Poland in 1996–2017. It aims to analyse the motivations of politicians responsible for civil service reforms and to assess the impact of these reforms on the effectiveness of the corps’ functioning. The authors conceptualise the problem of politicisation of the civil service by referring to the theory of politicisation adding an extra dimension of political ideas and institutions as an important factor of change in Poland’s public administration system. The article describes the stages of civil service reform in Poland over the last twenty years, taking into account the political context, the most important postulated changes and the associated controversies with reference to the concepts outlined in the theoretical part. The study also comprises a relevant literature review based on a number of sources, including the reports published by the Head of the Civil Service in Poland, international databases (including Quality of Government) and specialist reports with a particular emphasis on research devoted to Central Europe. The findings paint a multi-layered and nuanced picture of the evolution of the Polish civil service and its strong associations with the issue of the so-called “unfinished transformation”. In addition the article confirms that both the instrumentalisation of institutions by the “camp” of political opportunists and their formal, radical reconstruction by the “ideological contrarians” resulting in the centralisation of power around the ruling parties have had a negative effect on the quality of civil service functioning in Poland.

Evaluation of the Impact of a CPOE System on Nurse-physician Communication

2009 ◽  
Vol 48 (04) ◽  
pp. 350-360 ◽  
Author(s):  
Z. Niazkhani ◽  
H. van der Sijs ◽  
M. Berg ◽  
R. Bal ◽  
H. Pirnejad
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Medication Administration ◽  
Bonferroni Correction ◽  
Administration System ◽  
Communication Problems ◽  
Academic Medical ◽  
Internal Medicine Wards ◽  
Nurses And Physicians ◽  
The Impact

Summary Objectives: To assess the impact of a CPOE system on medication-related communication of nurses and physicians. Methods: In six internal medicine wards of an academic medical center, two questionnaires were used to evaluate nurses’ attitudes toward the impact of a paper-based medication system and then a CPOE system on their communication in medication-related-activities (medication work). The questionnaires were analyzed using t-tests, followed by Bonferroni correction. Nine nurses and six physicians in the same wards were interviewed after the implementation to determine how their communication and their work have been impacted by the system. Results: The total response rates were 54% and 52% for pre- and post-implementation questionnaires. It was shown that after im plementation, the legibility and completeness of prescriptions were significantly improved (P < .001) and the administration system had a more intelligible layout (P < .001), with a more reliable overview (P < .001). The analysis of the interviews supported and confirmed the findings of the surveys. Moreover, they showed communication problems that caused difficulties in integrating medication work of nurses into physicians’. To compensate for these, nurses and physicians devised informal interactions and practices (workarounds), which often represented risks for medication errors. Conclusion: The introduction of CPOE system with paper-based medication administration system improved prescription legibility and completeness but introduced many workflow impediments and as a result error-inducing conditions. In order to prevent such an effect, CPOE systems have to support the level of communication which is necessary to integrate the work of nurses and physicians.

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