Medication safety and knowledge-based functions: a stepwise approach against information overload

作者：Patapovas Andrius^*; Dormann Harald; Sedlmayr Brita; Kirchner Melanie; Sonst Anja; Mueller Fabian; Pfistermeister Barbara; Plank Kiegele Bettina; Vogler Renate; Maas Renke; Criegee Rieck Manfred; Prokosch Hans Ulrich; Buerkle Thomas

来源：British Journal of Clinical Pharmacology, 2013, 76: 14-24.

DOI：10.1111/bcp.12190

• decision support systems
• medication therapy management
• medical records system
• computerized
• electronic prescribing
• medication safety
• technology acceptance model

AIMS %26lt;br%26gt;The aim was to improve medication safety in an emergency department (ED) by enhancing the integration and presentation of safety information for drug therapy. %26lt;br%26gt;METHODS %26lt;br%26gt;Based on an evaluation of safety of drug therapy issues in the ED and a review of computer-assisted intervention technologies we redesigned an electronic case sheet and implemented computer-assisted interventions into the routine work flow. We devised a four step system of alerts, and facilitated access to different levels of drug information. System use was analyzed over a period of 6 months. In addition, physicians answered a survey based on the technology acceptance model TAM2. %26lt;br%26gt;RESULTS %26lt;br%26gt;The new application was implemented in an informal manner to avoid work flow disruption. Log files demonstrated that step I, %26apos;valid indication%26apos; was utilized for 3% of the recorded drugs and step II %26apos;tooltip for well-known drug risks%26apos; for 48% of the drugs. In the questionnaire, the computer-assisted interventions were rated better than previous paper based measures (checklists, posters) with regard to usefulness, support of work and information quality. %26lt;br%26gt;CONCLUSION %26lt;br%26gt;A stepwise assisting intervention received positive user acceptance. Some intervention steps have been seldom used, others quite often. We think that we were able to avoid over-alerting and work flow intrusion in a critical ED environment.

• 出版日期2013-9