Skip to main content
Erschienen in: Journal of Clinical Monitoring and Computing 3/2019

02.08.2018 | Original Research

Validation of a mobile app for reducing errors of administration of medications in an emergency

verfasst von: D. Baumann, N. Dibbern, S. Sehner, C. Zöllner, W. Reip, J. C. Kubitz

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Medication errors occur frequently and are a risk to patient safety. To reduce mistakes in the medication process in emergencies, a mobile app has been developed supporting the calculation of doses and administration of drugs. A simulation study was performed to validate the app as a tool to reduce medication errors. This was a randomised crossover study conducted in the Academic Hospital. The participants included were residents and attendings in anaesthesiology. 74 Participants performed four simulation scenarios in which they had to calculate and administer drugs for emergencies. Two scenarios were performed with the app (“app scenarios”) and the other two scenarios were performed without the use of the app (“control scenarios”). The order of drugs, simulation patients and usage of aid were randomized. The accuracy of administered drug doses were measured. Medications were categorised as either “accurate” (\(\pm 20\)% of target dosage) or “wrong” (less than 50% or more than 200% of target dosage). The dosage calculated and the dosage administered were documented separately to differentiate between calculation and handling errors. During app scenarios, there were no “wrong” dosages, whereas 6.8 (95% CI 2.7–10.8%) of dosages in control scenarios were evaluated as “wrong”. The probability of giving an “accurate” dosage was increased from 77.7 (70.9–84.5%) in control scenarios to 93.9 (90–97.8%) in app scenarios. Calculation errors were the main cause for wrong dosing. The app is an appropriate and feasible tool to reduce calculation and handling errors and may increase patient safety.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Walsh EK, Hansen CR, Sahm LJ, Kearney PM, Doherty E, Bradley CP. Economic impact of medication error: a systematic review. Pharmacoepidemiol Drug Saf. 2017;26(5):481–97.CrossRefPubMed Walsh EK, Hansen CR, Sahm LJ, Kearney PM, Doherty E, Bradley CP. Economic impact of medication error: a systematic review. Pharmacoepidemiol Drug Saf. 2017;26(5):481–97.CrossRefPubMed
2.
Zurück zum Zitat Bates DW, Boyle DL, Vliet Vander MB, Schneider J, Leape L. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995;10(4):199–205.CrossRefPubMed Bates DW, Boyle DL, Vliet Vander MB, Schneider J, Leape L. Relationship between medication errors and adverse drug events. J Gen Intern Med. 1995;10(4):199–205.CrossRefPubMed
3.
Zurück zum Zitat Ghaleb MA, Barber N, Franklin BD, Yeung VWS, Khaki ZF, Wong ICK. Systematic review of medication errors in pediatric patients. Ann Pharmacother. 2006;40(10):1766–76.CrossRefPubMed Ghaleb MA, Barber N, Franklin BD, Yeung VWS, Khaki ZF, Wong ICK. Systematic review of medication errors in pediatric patients. Ann Pharmacother. 2006;40(10):1766–76.CrossRefPubMed
4.
Zurück zum Zitat Hixson R, Gandhi M, Holton F. A randomised trial to evaluate prescribing accuracy when using the Paediatric Analgesia Wheel. Arch Dis Child. 2009;94(4):268–72.CrossRefPubMed Hixson R, Gandhi M, Holton F. A randomised trial to evaluate prescribing accuracy when using the Paediatric Analgesia Wheel. Arch Dis Child. 2009;94(4):268–72.CrossRefPubMed
5.
Zurück zum Zitat Lifshitz AE, Goldstein LH, Sharist M, Strugo R, Asulin E, Haim Bar S, Feigenberg Z, Berkovitch M, Kozer E. Medication prescribing errors in the prehospital setting and in the ED. Am J Emerg Med. 2012;30(5):726–31.CrossRefPubMed Lifshitz AE, Goldstein LH, Sharist M, Strugo R, Asulin E, Haim Bar S, Feigenberg Z, Berkovitch M, Kozer E. Medication prescribing errors in the prehospital setting and in the ED. Am J Emerg Med. 2012;30(5):726–31.CrossRefPubMed
6.
Zurück zum Zitat Bolt R, Yates JM, Mahon J, Bakri I. Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors. J Clin Pharm Ther. 2014;39(1):78–83.CrossRefPubMed Bolt R, Yates JM, Mahon J, Bakri I. Evidence of frequent dosing errors in paediatrics and intervention to reduce such prescribing errors. J Clin Pharm Ther. 2014;39(1):78–83.CrossRefPubMed
7.
Zurück zum Zitat Strauss J. New pediatric drug dosage aids. Med Klin Intensivmed Notf med. 2016;111(2):118–23.CrossRef Strauss J. New pediatric drug dosage aids. Med Klin Intensivmed Notf med. 2016;111(2):118–23.CrossRef
8.
Zurück zum Zitat Avidan A, Levin PD, Weissman C, Gozal Y. Anesthesiologists’ ability in calculating weight-based concentrations for pediatric drug infusions: an observational study. J Clin Anesth. 2014;26(4):276–80.CrossRefPubMed Avidan A, Levin PD, Weissman C, Gozal Y. Anesthesiologists’ ability in calculating weight-based concentrations for pediatric drug infusions: an observational study. J Clin Anesth. 2014;26(4):276–80.CrossRefPubMed
9.
Zurück zum Zitat Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Institute of Medicine (US) Committee on Quality of Health Care in America; 2000. Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Institute of Medicine (US) Committee on Quality of Health Care in America; 2000.
10.
Zurück zum Zitat Schnurrer JU, Frölich JC. Zur Häufigkeit und Vermeidbarkeit von tödlichen unerwünschten Arzneimittelwirkungen. Der Internist. 2003;44(7):889–95.CrossRefPubMed Schnurrer JU, Frölich JC. Zur Häufigkeit und Vermeidbarkeit von tödlichen unerwünschten Arzneimittelwirkungen. Der Internist. 2003;44(7):889–95.CrossRefPubMed
11.
Zurück zum Zitat Beaudoin FL, Merchant RC, Janicki A, McKaig DM, Babu KM. Preventing iatrogenic overdose: a review of in-emergency department opioid-related adverse drug events and medication errors. Ann Emerg Med. 2015;65(4):423–31.CrossRefPubMed Beaudoin FL, Merchant RC, Janicki A, McKaig DM, Babu KM. Preventing iatrogenic overdose: a review of in-emergency department opioid-related adverse drug events and medication errors. Ann Emerg Med. 2015;65(4):423–31.CrossRefPubMed
12.
Zurück zum Zitat Kaufmann J, Laschat M, Wappler F. Medication errors in pediatric emergencies: a systematic analysis. Dtsch Ärztebl Int. 2012;109(38):609–16.PubMedPubMedCentral Kaufmann J, Laschat M, Wappler F. Medication errors in pediatric emergencies: a systematic analysis. Dtsch Ärztebl Int. 2012;109(38):609–16.PubMedPubMedCentral
13.
Zurück zum Zitat Luten R. Error and time delay in pediatric trauma resuscitation: addressing the problem with color-coded resuscitation aids. Surg Clin N Am. 2002;82(2):303–14.CrossRefPubMed Luten R. Error and time delay in pediatric trauma resuscitation: addressing the problem with color-coded resuscitation aids. Surg Clin N Am. 2002;82(2):303–14.CrossRefPubMed
14.
Zurück zum Zitat Erker CG, Santamaria M, Möllmann M. Hilfsmittel für die Dosierung von Notfallmedikamenten im Kindesalter. Der Anaesth. 2012;61(11):965–70.CrossRef Erker CG, Santamaria M, Möllmann M. Hilfsmittel für die Dosierung von Notfallmedikamenten im Kindesalter. Der Anaesth. 2012;61(11):965–70.CrossRef
15.
Zurück zum Zitat Brinkrolf P, Prien T, Van Aken H. Medikationsfehler- Eine systematische Analyse der Berichte im CIRS-AINS. Anästhesiol Intensivmed. 2013;54:126–32. Brinkrolf P, Prien T, Van Aken H. Medikationsfehler- Eine systematische Analyse der Berichte im CIRS-AINS. Anästhesiol Intensivmed. 2013;54:126–32.
16.
Zurück zum Zitat Vilke GM, Tornabene SV, Stepanski B, Shipp HE, Ray LU, Metz MA, Vroman D, Anderson M, Murrin PA, Davis DP, Harley J. Paramedic self-reported medication errors. Prehosp Emerg Care. 2007;11(1):80–4.CrossRefPubMed Vilke GM, Tornabene SV, Stepanski B, Shipp HE, Ray LU, Metz MA, Vroman D, Anderson M, Murrin PA, Davis DP, Harley J. Paramedic self-reported medication errors. Prehosp Emerg Care. 2007;11(1):80–4.CrossRefPubMed
17.
Zurück zum Zitat Bernius M, Thibodeau B, Jones A, Clothier B, Witting M. Prevention of pediatric drug calculation errors by prehospital care providers. Prehosp Emerg Care. 2008;12(4):486–94.CrossRefPubMed Bernius M, Thibodeau B, Jones A, Clothier B, Witting M. Prevention of pediatric drug calculation errors by prehospital care providers. Prehosp Emerg Care. 2008;12(4):486–94.CrossRefPubMed
18.
Zurück zum Zitat Shah AN, Frush K, Luo X, Wears RL. Effect of an intervention standardization system on pediatric dosing and equipment size determination: a crossover trial involving simulated resuscitation events. Arch Pediatr Adolesc Med. 2003;157(3):229–36.CrossRefPubMed Shah AN, Frush K, Luo X, Wears RL. Effect of an intervention standardization system on pediatric dosing and equipment size determination: a crossover trial involving simulated resuscitation events. Arch Pediatr Adolesc Med. 2003;157(3):229–36.CrossRefPubMed
20.
Zurück zum Zitat Heimberg E, Heinzel O, Hoffmann F. Typische Probleme bei Kindernotfällen. Med Klin Intensivmed Notf med. 2015;110(5):354–9.CrossRef Heimberg E, Heinzel O, Hoffmann F. Typische Probleme bei Kindernotfällen. Med Klin Intensivmed Notf med. 2015;110(5):354–9.CrossRef
21.
Zurück zum Zitat Kaji AH, Gausche-Hill M, Conrad H, Young KD, Koenig WJ, Dorsey E, Lewis RJ. Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics. 2006;118(4):1493–500.CrossRefPubMed Kaji AH, Gausche-Hill M, Conrad H, Young KD, Koenig WJ, Dorsey E, Lewis RJ. Emergency medical services system changes reduce pediatric epinephrine dosing errors in the prehospital setting. Pediatrics. 2006;118(4):1493–500.CrossRefPubMed
22.
Zurück zum Zitat Ashcroft DM, Lewis PJ, Tully MP, Farragher TM, Taylor D, Wass V, Williams SD, Dornan T. Prevalence, nature, severity and risk factors for prescribing errors in hospital inpatients: prospective study in 20 UK hospitals. Drug Saf. (2015). https://doi.org/10.1007/s40264-015-0320-x. Ashcroft DM, Lewis PJ, Tully MP, Farragher TM, Taylor D, Wass V, Williams SD, Dornan T. Prevalence, nature, severity and risk factors for prescribing errors in hospital inpatients: prospective study in 20 UK hospitals. Drug Saf. (2015). https://​doi.​org/​10.​1007/​s40264-015-0320-x.
23.
Zurück zum Zitat Elashwah M. Medication errors in ambulatory paediatric patient setting how close, or far, are we from an error free process? Infect Disord Drug Targets. 2015;14(3):191–204.CrossRef Elashwah M. Medication errors in ambulatory paediatric patient setting how close, or far, are we from an error free process? Infect Disord Drug Targets. 2015;14(3):191–204.CrossRef
24.
Zurück zum Zitat Lammers R, Byrwa M, Fales W. Root causes of errors in a simulated prehospital pediatric emergency. Acad Emerg Med. 2012;19(1):37–47.CrossRefPubMed Lammers R, Byrwa M, Fales W. Root causes of errors in a simulated prehospital pediatric emergency. Acad Emerg Med. 2012;19(1):37–47.CrossRefPubMed
Metadaten
Titel
Validation of a mobile app for reducing errors of administration of medications in an emergency
verfasst von
D. Baumann
N. Dibbern
S. Sehner
C. Zöllner
W. Reip
J. C. Kubitz
Publikationsdatum
02.08.2018
Verlag
Springer Netherlands
Erschienen in
Journal of Clinical Monitoring and Computing / Ausgabe 3/2019
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-018-0187-3

Weitere Artikel der Ausgabe 3/2019

Journal of Clinical Monitoring and Computing 3/2019 Zur Ausgabe

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Häufigste Gründe für Brustschmerzen bei Kindern

06.05.2024 Pädiatrische Diagnostik Nachrichten

Akute Brustschmerzen sind ein Alarmsymptom par exellence, schließlich sind manche Auslöser lebensbedrohlich. Auch Kinder klagen oft über Schmerzen in der Brust. Ein Studienteam ist den Ursachen nachgegangen.

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.