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- Title
Intensive care unit nurse satisfaction with medication management before and after introduction of an electronic medication management system.
- Authors
SANTIAGO, CECILIA; SMITH, ORLA; BUTORAC, ELIZABETH; LEWIS, ELLEN; MUSTARD, MARY; POON, LISA; WILSON, GAIL
- Abstract
Background: Medication errors are common in the intensive care unit (ICU) and can result in adverse events. The electronic medication management system (EMMS) can ensure standardized medication-related processes and may reduce errors compared to traditional paper-based approaches. A significant proportion of nursing time in the ICU is dedicated to medication-related processes and, therefore, nurses' experiences with changing medication systems are important to elicit. Methods: We surveyed nurses in four ICUs in a large, academic, urban hospital before and six months after the introduction of EMMS using the 18-item Medication Administration System- Nurses' Assessment of Satisfaction (MAS-NAS) scale. Results: A total of 328 questionnaires were distributed both before and after with a response rate of 37% (n = 120) and 35% (n = 115) respectively. Overall satisfaction with the medication system was significantly higher after implementation of the electronic system (6.2 versus 7.0, p = 0.003). There were significantly higher scores on all items related to safety after implementation (p < 0.05) and two of six items related to access [access to systems that support medication administration (4.44 versus 4.89, p = 0.008) and availability of information about managing bad reactions (3.14 versus 3.81, p = 0.007)]. Nurses reported that the system was effective in reducing and preventing medication errors (3.24 versus 4.50, p < 0.001). However, there was no difference in nurses' perceptions of system efficiency (4.20 versus 4.42, p = 0.25). There was also no difference in the proportion who agreed that the system was user-friendly (68 versus 71%, p = 0.70) and, at both time points, a large proportion of nurses (45 versus 49%, p = 0.25) agreed they had to store stashes of medication to ensure access to those needed for patient care. Conclusion: Our study shows that the introduction of EMMS led to increased nurses' perceptions of safety and satisfaction. However, the system was not perceived as more efficient or userfriendly than the previously existing paper-based systems and, thus, resorted to workarounds and compliance to using barcode scanning when administering medication. Further research is needed to evaluate the impact of EMMS workarounds and non-compliance to barcode management system on ICU nursing workflows and patient outcomes.
- Publication
Canadian Journal of Critical Care Nursing, 2020, Vol 31, Issue 2, p20
- ISSN
2368-8653
- Publication type
Academic Journal