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One proven solution to decrease medication errors is use of medication software such as CPOE. It has significantly reduced errors in prescribing, transcription, and dispensing of medications (Hidle). It also has the potential to decrease errors in administration due to unfamiliarity with a drug, drugs with similar names, or incorrect dose calculations since the software performs the calculations. So, why are these systems not used more often in the administration of medications? In general, there has been reluctance on the part of nurses to use software programs. It is not known why this is, but it is thought that unfamiliarity with the technology, lack of training, and lack of involvement in the design of the software has caused this reluctance. Studies have shown that when used medical software has reduced medication errors due to administration (King). One major drawback is the lack of willingness to use the software. This could be alleviated by providing better training with the software as well as including nurses in the design of the software so that it will be convenient and relevant for their use. Another problem is the cost associated with implementing a software system such as CPOE. Hidle has suggested that a possible solution to this drawback would be to create a software system in house rather than purchasing pre-made medication software. Also, it has been found that warnings in the software meant to alert medical staff about drug interactions, and contraindications were either not seen or even ignored. This would defeat the purpose of the software entirely. Similarly to barcodes, software that does the "thinking" for nurses could be a major drawback if nurses do not remain alert and vigilant while administering medications. Likewise, if the software performs dosage calculations for nurses they will become out of practice at it and may not catch errors that can occur with the software. Software programs are not infallible. It is important that nurses use their knowledge and expertise when administering medications and not become over reliant on software.
Reliance on any one method, such as technology, is not wise. Nurses must still remain alert and vigilant to the five rights even with barcodes or medication software to assist with administration. If I were a nursing manager in charge of an acute surgical nursing unit experiencing repeated and frequent medication errors I would implement multiple solutions. I would begin by creating interruption free zones. This solution is low or no cost to implement. It requires little training and would produce results right away. Then, I would implement technological aids by using CPOE to avoid confusion about dosing and drug names along with barcodes to help with verification of the five rights. This would require a lot of training, especially with new staff, and nurse input upon implementation to avoid reluctance to and intimidation of technology. It would also be costly and might take years to fully implement. Finally, I would foster an open environment that encourages error reporting. With more accurate data about how and why medication errors occur, the healthcare industry will be better prepared to make positive changes to the system in the future.
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