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Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The computerized physician order entry (CPOE) systems ensure messy physicians’ handwriting is eliminated, with direct medication orders entered directly into the computer.
The institute of healthcare proposed the use of a trigger tool in order to measure the incidence of adverse drug events. What are the quality issues inPATIENT SAFETY and the potential impact of an effort to improve?
The nurses’ role in preventingmedication errorsIn administering any medication, nurses and midwives are required to:? Know the relevant legislation relating to medication administration? Have adequate knowledge of the medication, its therapeutic purpose, usual dose, frequency and route of administration, specific precautions, contra-indications, side effects and adverse reactions. Trigger Tool for Measuring AdverseDrug Events – Institute forHealthcare? The Trigger Tool for Measuring Adverse Drug Events provides instructions for conducting a retrospective review of patient records using triggers to identify possible ADEs. Studies have also found that by pairing the Computerised Physician Order Entry with automated clinical decision support systems (CDSS) this can also further eliminate medication errors by helping to improve drug choice, and with electronic health records to help complete the patient’s medication list and history.

However, researchin the public health sector (in the USA) have found that only 10 to 20 percent of errors are ever reported and, of those, 90 to 95 percent caused no harm to patients.
Improving Patient Safety by Modifying Provider Ordering Behaviour Using Alerts(CDSS) in CPOE system. Nurses and midwives should also be aware of the correct storage requirements for medications.? Adhere to required checking policies and procedures developed by agencies.
This tool includes a list of known ADE triggers and instructions for collecting the data you need to measure the number of ADEs per 1,000 doses and the percentage of admissions with an ADE.? The tool provides a process for accurately identifying ADEs and measuring the rate of ADEs over time. CDSS can help to identify drug allergy checking, basic dosing guidance, formulary decision support, and checks for duplicate therapies and drug to drug interactions.
Hospitals needed a more effective way to identify events that do cause harm to patients, in order to select and test changes to reduce harm, and so the institute for healthcare proposed a trigger tool be implemented. This example taken from the study highlights the learning process carried out when an alert system on computerised equipment is in place.

Nurses and midwives should also be aware of the correct storage requirements for medications, and be able to adhere to required checking policies and procedures developed by agencies.
The study reviewed electronic health records for all the inpatients coming to 5 community hospitals for a 6 months duration (July 2010 – December 2010). It shows that learning and changing behaviour occurs in most cases provided that action is taken, with the alert system working to remind providers of care necessary. Standardised ordering and administration includes, pre-packaging medications in the correct dosages, as well as standardising abbreviations, labelling and equipment, conventions such as limited and formally structured verbal order processes, and limited access to high-alert medications.Training, education and organisation interventions are also thought to influence the attitudes of the staff and staff development, and ensure that correct medication administration is completed and incorrect incidences are reduced. These alerts guided the providers regarding any drug duplications, interactions, contraindications of the prescribed medicine with patient’s clinical condition etc.

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