UCSF

Nursing and medication administration technologiesAbstract Amanda Egloff Background: In health care, a human error that results in an adverse event—an event that has a harmful or negative outcome on a patient receiving medical care—is one of the 10 leading causes of global death and disability. Among all types of adverse events in American health care settings, medication errors directly affect 7.1 million patients, costing approximately $21 billion annually. Medication administration technologies (MATs) are nursing-focused for the purpose of reducing medication errors: barcode medication administration (BCMA), automated dispensing cabinets (ADS), smart intravenous (IV) pumps, and electronic medication administration records (eMAR). Methods: This dissertation is divided into three projects: 1) an integrative literature review to understand how nurses work with medication administration technologies, 2) a meta-analysis to examine the pooled safety effectiveness of the technologies, and 3) a primary study to determine the prevalence of these technologies in the nursing home setting. Results: Although the qualitative literature identifies a conflict between system designs and nursing processes, the safety evidence is promising in indicating that medication errors are a manageable problem that can be solved with nursing-focused research. Furthermore, this study provides information about some of the nuances of implementing the medication administration technologies, such as California nursing homes’ lack of structural and financial resources. Conclusion: These three dissertation papers contribute to our understanding of how medication administration safety systems do not fully support the complex, critical thinking processes that nurses must perform prior to medication administration.