manias-interventionstoreduce-2012.pdf (1.09 MB)
Interventions to reduce medication errors in adult intensive care: a systematic review
journal contribution
posted on 2012-09-01, 00:00 authored by Elizabeth ManiasElizabeth Manias, A Williams, D LiewCritically ill patients need life saving treatments and are often exposed to medications requiring careful titration. The aim of this paper was to review systematically the research literature on the efficacy of interventions in reducing medication errors in intensive care. A search was conducted of PubMed, CINAHL EMBASE, Journals@Ovid, International Pharmaceutical Abstract Series via Ovid, ScienceDirect, Scopus, Web of Science, PsycInfo and The Cochrane Collaboration from inception to October 2011. Research studies involving delivery of an intervention in intensive care for adult patients with the aim of reducing medication errors were examined. Eight types of interventions were identified: computerized physician order entry (CPOE), changes in work schedules (CWS), intravenous systems (IS), modes of education (ME), medication reconciliation (MR), pharmacist involvement (PI), protocols and guidelines (PG) and support systems for clinical decision making (SSCD). Sixteen out of the 24 studies showed reduced medication error rates. Four intervention types demonstrated reduced medication errors post-intervention: CWS, ME, MR and PG. It is not possible to promote any interventions as positive models for reducing medication errors. Insufficient research was undertaken with any particular type of intervention, and there were concerns regarding the level of evidence and quality of research. Most studies involved single arm, before and after designs without a comparative control group. Future researchers should address gaps identified in single faceted interventions and gather data on multi-faceted interventions using high quality research designs. The findings demonstrate implications for policy makers and clinicians in adopting resource intensive processes and technologies, which offer little evidence to support their efficacy.
History
Journal
British journal of clinical pharmacologyVolume
74Issue
3Pagination
411 - 423Publisher
Wiley-Blackwell PublishingLocation
London, Eng.Publisher DOI
Link to full text
eISSN
1365-2125Language
engPublication classification
C Journal article; C1.1 Refereed article in a scholarly journalCopyright notice
2012, The AuthorsUsage metrics
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No categories selectedKeywords
intensive careinterventionmedication errorssystematic reviewAdultCritical CareCritical IllnessHumansIntensive Care UnitsPharmacistsPractice Guidelines as TopicProfessional RoleResearch DesignScience & TechnologyLife Sciences & BiomedicinePharmacology & PharmacyinterventionsPHYSICIAN ORDER ENTRYADVERSE DRUG EVENTSINFUSION PUMPSRISK-FACTORSIMPACTPARTICIPATIONPRESCRIPTIONANTIBIOTICSPHARMACISTPREVENTION
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