Medication Error in Hospitals and Effective Intervention Strategies: A Systematic Review

BACKGROUND The increasing screen time exposure among young children in general and the reported negative consequences associated with excessive ST, calls for focused strategies to reduce ST, especially among young children. OBJECTIVE This systematic review aimed to identify effective parental intervention strategies to reduce ST among preschool children. METHODS A total of five databases, namely Cochrane Central Register of Controlled Trials, CINAHL, Medline Complete, PubMed, and Scopus, were searched for randomised controlled trials that involved intervention strategies in ST reduction among preschool children. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were used. RESULTS A total of nine studies were assessed. The results showed that besides providing knowledge and awareness regarding ST, having restrictive practices, offering alternative activities to parents, and removal of screen from child’s bedroom were the most common strategies used by studies that reported successful intervention. Intervention duration of between six to eight weeks was sufficient to produce ST reduction. Face-to-face method was the commonest mode of delivery. Theoretical constructs that aimed at increasing parental self-efficacy, listing outcome expectations, and offering reinforcement of strategies that targeted both the parents and home environment were beneficial in reducing ST. CONCLUSIONS By offering appropriate strategies to parents, a reduction in the amount of ST was observed among the children. Future intervention studies could benefit in exploring culturally adapted strategies, especially in developing countries. Trials of higher quality would also facilitate the drawing of conclusions in future research. CLINICALTRIAL PROSPERO No: CRD42020199398

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How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocaa230 ◽

2020 ◽

Author(s):

Peter J Gates ◽

Rae-Anne Hardie ◽

Magdalena Z Raban ◽

Ling Li ◽

Johanna I Westbrook

Keyword(s):

Systematic Review ◽

Medication Error ◽

Medication Errors ◽

Meta Analysis ◽

Error Rates ◽

Prescribing Error ◽

Before And After ◽

Actual Harm ◽

Computer Based ◽

Wide Scale

Abstract Objective To conduct a systematic review and meta-analysis to assess: 1) changes in medication error rates and associated patient harm following electronic medication system (EMS) implementation; and 2) evidence of system-related medication errors facilitated by the use of an EMS. Materials and Methods We searched Medline, Scopus, Embase, and CINAHL for studies published between January 2005 and March 2019, comparing medication errors rates with or without assessments of related harm (actual or potential) before and after EMS implementation. EMS was defined as a computer-based system enabling the prescribing, supply, and/or administration of medicines. Study quality was assessed. Results There was substantial heterogeneity in outcomes of the 18 included studies. Only 2 were strong quality. Meta-analysis of 5 studies reporting change in actual harm post-EMS showed no reduced risk (RR: 1.22, 95% CI: 0.18–8.38, P = .8) and meta-analysis of 3 studies reporting change in administration errors found a significant reduction in error rates (RR: 0.77, 95% CI: 0.72–0.83, P = .004). Of 10 studies of prescribing error rates, 9 reported a reduction but variable denominators precluded meta-analysis. Twelve studies provided specific examples of system-related medication errors; 5 quantified their occurrence. Discussion and Conclusion Despite the wide-scale adoption of EMS in hospitals around the world, the quality of evidence about their effectiveness in medication error and associated harm reduction is variable. Some confidence can be placed in the ability of systems to reduce prescribing error rates. However, much is still unknown about mechanisms which may be most effective in improving medication safety and design features which facilitate new error risks.

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Economic impact of medication error: a systematic review

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.4188 ◽

2017 ◽

Vol 26 (5) ◽

pp. 481-497 ◽

Cited By ~ 28

Author(s):

Elaine K. Walsh ◽

Christina Raae Hansen ◽

Laura J. Sahm ◽

Patricia M. Kearney ◽

Edel Doherty ◽

...

Keyword(s):

Systematic Review ◽

Medication Error ◽

Economic Impact

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Multi-Step Tail Biting Outbreak Intervention Protocols for Pigs Housed on Slatted Floors

Animals ◽

10.3390/ani9080582 ◽

2019 ◽

Vol 9 (8) ◽

pp. 582 ◽

Cited By ~ 7

Author(s):

Jen-Yun Chou ◽

Keelin O’Driscoll ◽

Rick B. D’Eath ◽

Dale A. Sandercock ◽

Irene Camerlink

Keyword(s):

Cost Effective ◽

Intervention Strategies ◽

Effective Intervention ◽

Know How ◽

Tail Biting

Solutions are needed to keep pigs under commercial conditions without tail biting outbreaks (TBOs). However, as TBOs are inevitable, even in well managed farms, it is crucial to know how to manage TBOs when they occur. We evaluated the effectiveness of multi-step intervention protocols to control TBOs. Across 96 pens (1248 undocked pigs) managed on fully-slatted floors, 40 TBOs were recorded (≥3 out of 12–14 pigs with fresh tail wounds). When an outbreak was identified, either the biters or the victims were removed, or enrichment (three ropes) was added. If the intervention failed, another intervention was randomly used until all three interventions had been deployed once. Fifty percent of TBOs were controlled after one intervention, 30% after 2–3 interventions, and 20% remained uncontrolled. A high proportion of biters/victims per pen reduced intervention success more so than the type of intervention. When only one intervention was used, adding ropes was the fastest method to overcome TBOs. Removed biters and victims were successfully reintroduced within 14 days back to their home pens. In conclusion, 80% of TBOs were successfully controlled within 18.4 ± 1.7 days on average using one or multiple cost-effective intervention strategies.

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Diversity of practices in telerehabilitation for children with disabilities and effective intervention characteristics: results from a systematic review

Disability and Rehabilitation ◽

10.1080/09638288.2019.1595750 ◽

2019 ◽

Vol 42 (24) ◽

pp. 3424-3436 ◽

Cited By ~ 8

Author(s):

Chantal Camden ◽

Gabrielle Pratte ◽

Florence Fallon ◽

Mélanie Couture ◽

Jade Berbari ◽

...

Keyword(s):

Systematic Review ◽

Children With Disabilities ◽

Effective Intervention

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Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis

Implementation Science ◽

10.1186/s13012-020-01054-3 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Md Golam Hasnain ◽

John R. Attia ◽

Shahinoor Akter ◽

Tabassum Rahman ◽

Alix Hall ◽

...

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Publication Bias ◽

Behaviour Change ◽

Intravenous Thrombolysis ◽

Intervention Strategies ◽

Therapeutic Window ◽

Behaviour Change Wheel ◽

Meta Analyses

Abstract Background Despite being one of the few evidence-based treatments for acute ischemic stroke, intravenous thrombolysis has low implementation rates—mainly due to a narrow therapeutic window and the health system changes required to deliver it within the recommended time. This systematic review and meta-analyses explores the differential effectiveness of intervention strategies aimed at improving the rates of intravenous thrombolysis based on the number and type of behaviour change wheel functions employed. Method The following databases were searched: MEDLINE, EMBASE, PsycINFO, CINAHL and SCOPUS. Multiple authors independently completed study selection and extraction of data. The review included studies that investigated the effects of intervention strategies aimed at improving the rates of intravenous thrombolysis and/or onset-to-needle, onset-to-door and door-to-needle time for thrombolysis in patients with acute ischemic stroke. Interventions were coded according to the behaviour change wheel nomenclature. Study quality was assessed using the QualSyst scoring system for quantitative research methodologies. Random effects meta-analyses were used to examine effectiveness of interventions based on the behaviour change wheel model in improving rates of thrombolysis, while meta-regression was used to examine the association between the number of behaviour change wheel intervention strategies and intervention effectiveness. Results Results from 77 studies were included. Five behaviour change wheel interventions, ‘Education’, ‘Persuasion’, ‘Training’, ‘Environmental restructuring’ and ‘Enablement’, were found to be employed among the included studies. Effects were similar across all intervention approaches regardless of type or number of behaviour change wheel-based strategies employed. High heterogeneity (I2 > 75%) was observed for all the pooled analyses. Publication bias was also identified. Conclusion There was no evidence for preferring one type of behaviour change intervention strategy, nor for including multiple strategies in improving thrombolysis rates. However, the study results should be interpreted with caution, as they display high heterogeneity and publication bias.

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Impact of Theory of Accident Causation on Intervention Strategies

Proceedings of the Human Factors Society Annual Meeting ◽

10.1177/107118137902300158 ◽

1979 ◽

Vol 23 (1) ◽

pp. 225-229 ◽

Cited By ~ 2

Author(s):

Jasper E. Shealy

Keyword(s):

Data Base ◽

Intervention Strategies ◽

The Other ◽

Effective Intervention ◽

Accident Causation ◽

Accident Data ◽

The Way

Paper shows how the belief that one has about how accidents happen (Theory of Accident Causation) affects the design of the Accident Report Form, the type of information gathered, the nature of your accident data base, the analysis of the data and, finally, the way in which you intervene in the situation. Two different approaches are examined, one which is typical of most existing systems, the other represents a much improved system that points the way to more effective intervention strategies.

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