Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/103870
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Stepped-wedge cluster randomised controlled trial to assess the effectiveness of an electronic medication management system to reduce medication errors, adverse drug events and average length of stay at two paediatric hospitals: a study protocol
Author: Westbrook, J.
Li, L.
Raban, M.
Baysari, M.
Mumford, V.
Prgomet, M.
Georgiou, A.
Kim, T.
Lake, R.
McCullagh, C.
Dalla-Pozza, L.
Karnon, J.
O'Brien, T.
Ambler, G.
Day, R.
Cowell, C.
Gazarian, M.
Worthington, R.
Lehmann, C.
White, L.
et al.
Citation: BMJ Open, 2016; 6(10):e011811-1-e011811-11
Publisher: BMJ Publishing Group
Issue Date: 2016
ISSN: 2044-6055
2044-6055
Statement of
Responsibility: 
JI Westbrook, L Li, MZ Raban, MT Baysari, V Mumford, M Prgomet, A Georgiou, T Kim, R Lake, C McCullagh, L Dalla-Pozza, J Karnon, TA O’Brien, G Ambler, R Day, CT Cowell, M Gazarian, R Worthington, CU Lehmann, L White, D Barbaric, A Gardo, M Kelly, P Kennedy
Abstract: INTRODUCTION: Medication errors are the most frequent cause of preventable harm in hospitals. Medication management in paediatric patients is particularly complex and consequently potential for harms are greater than in adults. Electronic medication management (eMM) systems are heralded as a highly effective intervention to reduce adverse drug events (ADEs), yet internationally evidence of their effectiveness in paediatric populations is limited. This study will assess the effectiveness of an eMM system to reduce medication errors, ADEs and length of stay (LOS). The study will also investigate system impact on clinical work processes. METHODS AND ANALYSIS: A stepped-wedge cluster randomised controlled trial (SWCRCT) will measure changes pre-eMM and post-eMM system implementation in prescribing and medication administration error (MAE) rates, potential and actual ADEs, and average LOS. In stage 1, 8 wards within the first paediatric hospital will be randomised to receive the eMM system 1 week apart. In stage 2, the second paediatric hospital will randomise implementation of a modified eMM and outcomes will be assessed. Prescribing errors will be identified through record reviews, and MAEs through direct observation of nurses and record reviews. Actual and potential severity will be assigned. Outcomes will be assessed at the patient-level using mixed models, taking into account correlation of admissions within wards and multiple admissions for the same patient, with adjustment for potential confounders. Interviews and direct observation of clinicians will investigate the effects of the system on workflow. Data from site 1 will be used to develop improvements in the eMM and implemented at site 2, where the SWCRCT design will be repeated (stage 2). ETHICS AND DISSEMINATION: The research has been approved by the Human Research Ethics Committee of the Sydney Children's Hospitals Network and Macquarie University. Results will be reported through academic journals and seminar and conference presentations. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ANZCTR) 370325.
Keywords: electronic prescribing; adverse drug events
Rights: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/
RMID: 0030057353
DOI: 10.1136/bmjopen-2016-011811
Grant ID: http://purl.org/au-research/grants/nhmrc/1094878
Appears in Collections:Public Health publications

Files in This Item:
File Description SizeFormat 
hdl_103870.pdfPublished version1.96 MBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.