Evidence Based Process:

1. Evidence Based Process: Medication Errors Amy Moore, Shannon Walden and Kim Alexander

2. Case Study XYZ hospital is experiencing a drastic increase in medication errors. The increased errors prompted the Quality Improvement Committee to investigate. The Committee is aware that a competitive facility located across town has been using new technology to prevent medication errors. Administration charged the Committee with examining the feasibility of adopting and purchasing a new systems or products. Administration noted that cost, training of personnel, and barriers to new innovations would need to be identified by the committee.

3. Situation Focused Question • Purpose and Goal • To decrease medication errors at XYZ hospital. • Focused Question • What are the benefits versus the costs of hospitals using a system of electronic medication administration to reduce medication errors?

4. Introduction Injury and death attributable to medication errors presents a substantial dilemma in the United States (U.S.). According to Anderson et al., “The annual cost of morbidity and mortality due to medication errors in the U.S. has bee estimated at $76.6 billion.”

5. Targeted Resources • CINAHL • Plus • Pubmed • These sources were chosen because they contain meta-analyses and systematic reviews concerning the category of prevention of medication errors and are at the highest level of the evidence pyramid.

6. The Search After choosing which databases would be used in the search for best evidence, the focused question was developed using the PPAARE method.

7. Relevant Evidence Benefits to Electronic Medication administrations • Reducing medication errors. • Improving patient safety. • Reducing cost of medication errors Cost of Electronic Medication Administration • “Five year estimated cost of electronic pharmacy management and drug repacking is $40,000 per BCMA-enable bed” (Sakowski and Ketchel, 2013, np). • “ Five year estimated cost of electronic pharmacy management and drug repacking is $2,000 per harmful error prevented” (Sakowski and Ketchel, 2013, np).

8. Evidence Appraisal • A critical step in the EBP process is appraisal of evidence for validity, both external and internal, reliability and objectivity. • A quantitative study by Anderson et al., was appraised for trustworthiness using question developed by Howlett, Rogo and Shelton. After analysis, the study was found to be trustworthy. • Another relevant quantitative study conducted by Sakowski and Ketchel was also appraised for trustworthiness. After analysis of this study, it was found to be trustworthy.

9. Plan of Action • The team determined that the best plan of action is to implement such a system. In order to accomplished this transition smoothly, several steps must be completed: • Select a provider of the new computer system. • Establish a management team. • Analyze each job from paper to electronic. • Customize the software to XYZ hospital. • Because of the benefits of an electronic medication records system, XYZ hospital will implement the new system to reduce medication errors.

10. Conclusion The benefits prevail over the costs of using a system of electronic medication administration to reduce medication errors and to improve patient safety.

11. References Anderson, J.G., Anderson, M., Hunt, T.J., & Jay, S.J. (2002). Evaluating the capability of information technology to prevent adverse drug events: A computer simulation approach. Journal of the American Medical Informatics Association, 9(5), 1-12. Retrieved from http://search.proquest.com/docview/220775321?accountid=6370 Sakowski, J., & Ketchel, A., (2013, February 1). The cost of implementing inpatient bar code medication administration, American Journal of Managing Care, 19(9), 38-45. Retrieved from http://www.tandfonline.com/doi/abs/10.3200/HTPS.84.4.3-8 Medication errors. [photograph]. (2013, October 20). Retrieved October 16, 2013, from: http://txmedobserver.com/news/medication-errors-in-the-elderly-are-costing-at-least-4-2-billion-annually-proof-of-concept-study-points-to-a-solution/

12. References Automated medication administration solutions. [photograph]. Retrieved October 16, 2013, from:http://bciincorporated.com/solutions/healthcare/medication-administration Electronic medication and treatment administration. [photograph]. Retrieved October 16 2013, from: http://mpsrx.com/pharmacy_services/services/administer.aspx Improving nursing care through technology. [photograph]. (2008). Retrieved October 16, 2013, from: http://hinnovic.org/improving-nursing-care-through-technology/