![]() While there is little empirical evidence for the impact (negative or positive) of these workarounds on patient safety, not using EMMS appropriately undermines the potential to isolate and measure the impact of EMMS on medication error and may increase the potential for error. ![]() EMMS workarounds include not taking an electronic medication administration record to the patient preparing medications for multiple patients concurrently entering medication as administered before having done so and signing off medication in the EMMS that has been administered by another nurse. Rather, nurses use ‘workarounds’-practices that differ from organisationally prescribed or intended procedures-to circumvent perceived or actual hindrances to achieving a goal. Yet, nurses do not always use EMMS as intended. Implementing EMMS has reduced errors in documentation and prescribing and administration and has improved adherence to safety guidelines. EMMS are designed to digitise administration processes, structure medication-related tasks, provide information support and promote adherence to medication administration policies. ![]() One common approach has been the implementation of Electronic Medication Management Systems (EMMS). Internationally, sustained efforts endeavour to reduce medication error rates. In addition to harming patients, medication errors undermine patients’ confidence in the healthcare system, extend hospital length of stay and are costly. Medication errors cause significant iatrogenic harm in hospitals worldwide and are estimated to occur in 5–10% of in-hospital medication administrations. The TDF provides a useful approach to identify barriers to nurses’ prescribed use of EMMS, and can inform the design of targeted theory-based interventions to improve EMMS implementation. It proposes several targeted interventions to deliver these BCTs. Seven BCTs to address Social/Professional Role and Identity were identified: social process of encouragement pressure or support information about others’ approval incompatible beliefs identification of self as role model framing/reframing social comparison and demonstration of behaviour. The study identified three potential BCTs to address the Environmental Context and Resources domain barrier: adding objects to the environment restructuring the physical environment and prompts and cues. Two closely linked domains emerged as major barriers to EMMS use: Environmental Context and Resources (availability and properties of computers on wheels (COWs) technology characteristics specific contexts competing demands and time pressure) and Social/Professional Role and Identity (conflict between using EMMS appropriately and executing behaviours critical to nurses’ professional role and identity). Resultsīarriers to nurses’ use of EMMS in acute care were represented by nine domains of the TDF. Relevant behaviour change techniques (BCTs) were identified to overcome key barriers to using EMMS (step 3) followed by the identification of potential literature-informed targeted intervention strategies to operationalise the identified BCTs (step 4). Data were analysed using the TDF to identify theory-derived barriers to nurses’ appropriate use of EMMS (step 2). Interviews inductively explored nurses’ experiences of using EMMS (step 1). Nurses working on the study units ( N = 6) in two hospitals were invited to participate if available during the data collection period. A convenience sampling approach was used. This qualitative study draws on in-depth interviews with 19 acute care nurses who used EMMS. This study uses the Theoretical Domains Framework (TDF) to identify barriers and targeted interventions to enhance nurses’ appropriate use of EMMS in two Australian hospitals. However, nurses do not always use EMMS as intended, largely because implementation of such patient safety strategies requires clinicians to change their existing practices, routines and behaviour. Electronic Medication Management Systems (EMMS) have been shown to reduce medication errors. ![]() Medication errors harm hospitalised patients and increase health care costs.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |