Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study

Frank H Morriss Jr; Paul W Abramowitz; Steven P Nelson; Gary Milavetz; Stacy L Michael; Sara N Gordon; Jane F Pendergast; E Francis Cook

doi:10.1016/j.jpeds.2008.08.025

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Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study

Journal article

Peer reviewed

Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study

Frank H Morriss Jr, Paul W Abramowitz, Steven P Nelson, Gary Milavetz, Stacy L Michael, Sara N Gordon, Jane F Pendergast and E Francis Cook

The Journal of pediatrics, Vol.154(3), pp.363-368.e1

03/2009

DOI: 10.1016/j.jpeds.2008.08.025

PMID: 18823912

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Abstract

Patients are at risk of harm from medication errors. Barcode medication administration (BCMA) systems are recommended to mitigate preventable adverse drug events (ADEs). Our hypothesis was that a BCMA system would reduce preventable ADEs by 45% in a neonatal intensive care unit. We conducted a prospective, observational, cohort study of a BCMA system intervention in a neonatal intensive care unit. Participants were admitted neonates during 50 weeks. Medication errors and potential or preventable ADEs were detected by a daily structured audit of each subject's medical record, with assignment of an event as a preventable ADE made by blinded assessors. The generalized estimating equation method was used in modeling the targeted, preventable ADE rate with covariates. A total of 92,398 medication doses were administered to 958 subjects. The generalized estimating equation method yielded a relative risk of preventable ADE when the system was implemented of 0.53 (95% confidence limits 0.29 to 0.91, P = .04), adjusted for log(10)doses of medication/subject/day, a significant predictive covariate (P < .001), as well as for birth weight, sex, Caucasian race, birth cohort number, and nursing hours/subject/day. The BCMA system reduced the risk of targeted, preventable ADEs by 47%, controlling for the number of medication doses/subject/day, an important risk exposure.

Automatic Data Processing - methods

Automatic Data Processing - organization & administration

Drug-Related Side Effects and Adverse Reactions - etiology

Drug-Related Side Effects and Adverse Reactions - prevention & control

Humans

Infant, Newborn

Intensive Care Units, Neonatal - organization & administration

Medication Errors - adverse effects

Medication Errors - prevention & control

Medication Systems, Hospital

Outcome Assessment (Health Care)

Program Evaluation

Prospective Studies

Risk Management - methods

Risk Management - organization & administration

Details

Title: Subtitle: Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study
Creators: Frank H Morriss Jr - Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA. frankmorriss@uiowa.edu
Paul W Abramowitz - University of Iowa
Steven P Nelson
Gary Milavetz - Division of Clinical and Administrative Pharmacy, College of Pharmacy, Iowa City, IA
Stacy L Michael - University of Iowa Stead Family Children’s Hospital
Sara N Gordon
Jane F Pendergast - University of Iowa
E Francis Cook - Brigham and Women's Hospital
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.154(3), pp.363-368.e1
DOI: 10.1016/j.jpeds.2008.08.025
PMID: 18823912
ISSN: 0022-3476
eISSN: 1097-6833
Language: English
Date published: 03/2009
Academic Unit: Pharmacy; Stead Family Department of Pediatrics; Biostatistics; Pharmacy Practice and Science
Record Identifier: 9984365881202771

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