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A POCKET GUIDE TO MINIMISE USER ERRORS RELATED TO PATIENTS’ MEDICATION LISTS IN THE ELECTRONIC CHARTING SYSTEM MEONA

European Statement

Patient Safety and Quality Assurance

Author(s)

E Biringer1,2, K Skaare-Fatland1, E Tverborgvik3
1Helse Fonna Local Health Trust, Haugesund, Norway, eva.biringer@helse-fonna.no
2Western Norway University of Applied Sciences, Stord, Norway
3Sjukehusapoteka Vest HF, Stord, Norway

Why was it done?

Why was it done?
The aim was to reduce the risk of medication errors arising during the registration and reconciliation of patients’ medication lists in the electronic charting system MEONA (Mesalvo GmbH, Freiburg, Germany) at patient admission. Prior to the intervention, medication errors were frequent, most likely due to limited MEONA proficiency among newly employed staff and a complex procedure for importing information about patients’ current medications from multiple sources, i.e. the electronic patient records, the Summary Care Record («Kjernejournal») and the Prescription Intermediary («Reseptformidleren»). The initiative was made in 2022 in a mental health hospital in Norway.

What was done?

What was done?
A concise pocket guide was developed for use by health personnel responsible for the registration and reconciliation of medication lists at the acute mental health ward.

How was it done?

The process of registration and reconciliation of medication lists was standardised and visually illustrated by simplified step-by-step illustrations of the user-interfaces of MEONA. The illustrations were included in a two-page pocket-sized brochure along with illustrations pertaining to electronic registrations of patient information in the electronic patient administrative- and laboratory systems. The hospital pharmacist advised the development of the brochure. The communications department of the health trust created the illustrations and lay-out of the brochure.

What has been achieved?

A qualitative evaluation was conducted based on feedback from end-users of the brochure, i.e. the physicians regularly performing medication-related operations in MEONA. They all reported a reduction in erroneous registrations and less time spent on hazzles related to medication reconciliation after the pocket guide was implemented. A newly employed junior doctor stated:
“I think the brochure is excellent! I would have had significantly more trouble during my shifts if I hadn’t had this little guide with me.”

What next?

This simple intervention likely contributed to reducing the risk of medication-related errors in the mental health hospital. Hospital pharmacists could develop similar brochures in other hospitals with electronic charting systems subject to user errors. The efficiency of such pocket guides in terms of reducing erroneous registrations and time spent on registrations should be measured prior to and after their introduction.

COMPUTERISATION OF THE REQUEST MANAGEMENT OF MEDICAL PRODUCTS UNDER SPECIAL CIRCUMSTANCES

European Statement

Selection, Procurement and Distribution

Author(s)

A. Navarro Ruíz, A. Martínez Valero, R. Gutiérrez Vozmediano, A. Andújar Mateos, A. Martí Lorca, I. Jiménez Pulido

Why was it done?

The purpose was to increase the efficiency of this management process involving a high workload due in part to the absence of information.

What was done?

In Spain, the availability of drugs under special circumstances is regulated by the Spanish Royal Decree 1015/2009 of 20 June, which established three instances: (1) use of investigational medicinal product undergoing a clinical trial, (2) use of medical products for a medical purpose not in accordance with the authorised product information (off-label use) and (3) access to unauthorised medicines in our state but which are legally marketed in other states. Also, each region has its own regulatory system for medicines. In the pharmacy department, we have developed a software application for managing requests for medicinal products in the situations described above, and in accordance with our region’s regulations. It is organised in different sections that collect patients, prescribing physician details, medicinal products and diagnostic information. It has restricted access through user accounts and a menu for multiple search parameters.

How was it done?

In the pre-design phase, we held individual meetings with pharmaceutical and administrative staff involved in this process to identify their specific needs and priorities, and to assess these once the software application was created. The database management system used for the development of the computer application was Microsoft Access 2003. Once finished, it was tested for 2 months to help pinpoint specific errors and improvement opportunities.

What has been achieved?

Computerisation of this process has improved the efficiency in requests management, facilitating the use of information, increasing speed and reliability, allowing the possibility of analysing large volumes of data, providing greater confidentiality and increasing security through backups.

What next?

The next step will be to assess the usefulness of this software application using a satisfaction survey. To incorporate this initiative into other hospitals in our area requires only compatible software able to run the application.To extend its use to other regions would need adaptation of this software application to the existing regulations in each region.