Study characteristics
Study | Type of ward | Hospital | Setting pre-intervention | Setting post-intervention | Other points of interest | Observation period |
---|---|---|---|---|---|---|
Paoletti et al9 | Cardiac (telemetry)Medical-surgical | 20-bed cardiac ward 36-bed medicalSurgical ward in a general hospital, Lancaster, USA | Decentralised cabinet distribution systemHandwritten orderHandwritten paper MAR | Decentralised cabinet distribution systemHandwritten ordereMAR with pharmacist order entryBCMA | 1.5 year surveillance data | ND |
Poon et al10 | ICUMedicalSurgical | 35 units in a 735-bed tertiary academic medical centre, Boston, USA | CPOEMAR transcribed by nurses | CPOEeMARBCMA | Transcription errorsSeverity classification of potential ADEs2 year surveillance data (in supplement) | 2–4 weeks before and 4–8 weeks afterwards. 4 h observation of staff nurses on 35 observed units |
Franklin et al11 | Surgical | 28-bed ward in a teaching hospital, London, UK | Stock cupboards and two drug trolleysDrug prescription on paper MAR | ADC and two electronic drug trolleysCPOE bar code scan used to confirm drug identity when loading medication into drawer ADC and for patient identificationeMAR with manual confirmation of administration | Prescribing errorsStaff time spent on medication tasksPotential severity assessment of observed errors | 3–6 months before and 6–12 months after.Sample of 56 drug rounds before and 55 after (including nights and weekends) during a 2-week period |
Helmons et al12 | ICU (medical-surgical)Medical-surgical | 13- and 20-bedICU22-, 26-bed medical surgical ward in a 386-bed academic teaching hospital, San Diego, USA | Unit-based ADCsCPOEPrinted paper MAR manually updated | Unit-based ADCsCPOEeMARBCMA | Medication administration accuracyTime spent on medication tasks | 1 month before and 3 months after implementation. During week and weekend days focus on medication round 09:00 |
DeYoung et al13 | ICU | 38-bed medical ICU in a 744-bed community teaching hospital, Grand Rapids, USA | ND | Handwritten or preprinted orders eMAR with pharmacist order entryBCMA | – | 1 month before and 4 months after. 24 h a day during 4 days |
Morris14 | NICU | 36-bed ward in a children's hospital, Iowa City, USA | Handwritten orders entered by pharmacist in pharmacy information systemPaper MAR on which orders were transcribed and administrations recorded | Handwritten orders entered by pharmacist in pharmacy information systemeMAR bidirectionally interfaced with pharmacy information systemBCMA | Severity assessment of observed preventable ADEs | 19 consecutive weeks before implementation and 1 month after implementation during 31 weeks |
Ros et al, 20 Wesselink et al 21 | Neurological | 42-bed ward, community teaching hospital, Apeldoorn, The Netherlands | Dispensing to the ward from pharmacy by drug trolleyCPOEeMAR with manual confirmation of administration | BAP cartCPOEeMARBCMA | Time spent on medication tasks | 1 year and 8 months before and 3 months after. Three daily medication rounds during 21 days |
ADC, automated dispending cabinet; ADE, adverse drug events; BAP, bedside assortment picking; BCMA, bar code-assisted medication administration; CPOE, computerised physician order entry; eMAR, electronic medication administration record; ICU, intensive care unit; MAR, medication administration record; ND, not determined.