Building a Bridge

Building a Bridge Between Evidence based knowledge and the Point of Care to prevent medical errors when Prescribing:

Building a Bridge Between Evidence based knowledge and the Point of Care to prevent medical errors when Prescribing Viviana Lara Brandman University

The Main Issue:

The Main Issue Integrating research into clinical practice Access to information resources at point of care Medical errors at point of care.

Why it is an issue:

Why it is an issue Preventing errors Outdated references Aging textbooks and journals with outdated information Difficult to locate relevant information Limited information sharing S maller networks Delays in communication

What the Research shows:

What the Research shows Previous studies have documented that medical knowledge sources accessible at the point of care will increase the extent to which research findings are incorporated into daily routines . Moody and Shanks and Balas and Boran 8-17 years for evidence to be incorporated into practice Hardwick et al. (2007) shows that handheld technology can be used by nurses to improve and streamline patient care by capturing clinical data, organizing and reporting home health services, and by providing references for evidence based practice. Droan (2009) found that PDAs can be useful for promoting timely communication, enabling evidence-based collaborative practice and in supporting work place learning. Research in the UK found that a key point in providing evidence at the point of care was identified as the speed at which the information can be delivered. The resources most frequently referenced in clinical settings were: drug reference information, medical calculators, guidelines information, and administrative tasks. 90% of clinical staff with access to the latest medical knowledge at the point of care found that quality was improved.

Research Findings continued:

Research Findings continued A study in the Journal of Pain (January) reported that 40 percent of analgesic medication errors have one or more of the following characteristics: availability in dose forms for multiple routes of administration, modified dosage forms, atypical dosage regimens, sound-alike drug names, and analgesic use on an ongoing scheduled basis . Another study conducted in four hospitals in California found that from the 177 clinical records studied 69 patients or 39 percent had at least one medication record. With a total of 84 medication errors identified among those 69 patients. And 21 of these patients or 30 percent were attributable to doctors. 2005- MEDMARX reported more than 1 million errors 28 percent of adverse drug events (ADE)

The Solution:

The Solution iPharmacy Professional- 7000 commonly prescribed drugs Built in drug identifier recognizes 50,000 packages Literature search for core clinical journals Ability copy and paste to other apps Ability to notate

The Collaborators:

The Collaborators The Doctor The Physician Assistant The Nurse Practitioner

Cost of implementation:

Cost of implementation Cost of an Ipod 64 GB- $399 Cost of 2 year protection plan $59 Cost of I Pharmacy Professional $1.99 Training costs $0- 100 as application is user friendly. Total Startup for a 6 provider clinic $2760-2860 Future costs : replacement device and update if not free.

References:

References Burdette, S. D., Herchline , T. E., & Oehler , R. (2008). Practicing Medicine in a Technological Age : Using Smartphones in Clinical Practice. Clinical Infectious Diseases , 47(1), 117122 . doi:10.1086/588788 Contributing factors for prescribing errors.  March 2011 p13(1) AAOS Now , p.13(1). Retrieved  2011, from Academic OneFile via Gale: http://find.galegroup.com.libproxy.chapman.edu/gtx/start.do?prodId=AONE&userGroupName= chap_main Doran, D. M., Haynes, R. B., Kushniruk , A., Straus, S., Grimshaw , J., Hall, L. M., Dubrowski , A ., Di Pietro , T., Newman, K., Almost, J., Nguyen, H., Carryer , J. and Jedras , D. (2010), Supporting Evidence-Based Practice for Nurses through Information Technologies. Worldviews on Evidence-Based Nursing, 7: 4–15. doi : 10.1111/j.1741 -6787.2009.00179 .x Ducut , E., & Fontelo, P. (2008). Mobile Devices in Health Education: Current Use and Practice. Journal of Computing in Higher Education , 20(2), 59-68. Retrieved from EBSCO host Ettelt , S.,Nolte , E., McKee M.,Haugen , O.A., Karlberg , I., Klazinga , N. Riccardi , W., Teperi , J. ( 2006) Evidence-based policy? The use of mobile phones in hospital. Journal of Public Health, 23(4), Retrieved from http:// apps.isiknowledge.com.libproxy.chapman.edu / CitedFullRecord.do ? product =WOS&SID=4F8dhnkaihIgCIfdPdO& search _mode = CitedFullRecord &isickref =153402870&db_id= WOS&colname = WOS Horwitz , L.I., & Detsky , A.S. (2011). Physician communication in the 21st century: to talk or to text ?. JAMA , 305 (11), Retrieved from http:// jama.ama assn.org.libproxy.chapman.edu / content/305/11/1128. full sid =4179b8d8-8d99-4447 -8734 1d03ea782f78 Keng , S., & Zixing , S. (2006). Mobile healthcare informatics. Medical Informatics & the Internet in Medicine , 31(2), 89-99. doi:10.1080/ 14639230500095651

References Continued:

References Continued Leon, S., Fontelo, P., Green, L., Ackerman, M., & Liu, F. (2007). Evidence-based medicine among internal medicine residents in a community hospital program using smart phones. BMC Medical Informatics & Decision Making , 75-11. Retrieved from EBSCO host . Mehta , S, & Gogtay , N (Jan-March 2005). From the pen to the patient: Minimising medication errors. Journal of Postgraduate Medicine , 51, 1. p.NA . Retrieved, from Academic OneFile via Gale: http:// find.galegroup.com.libproxy.chapman.edu / gtx / start.do?prodId = AONE&userGroupName = chap_main Moody, D. and S. G. (1999). Using Knowledge Management and the Internet to Support Evidence Based Practice: A Medical Case Study. The 10th Australasian Conference on Information Systems , Victoria University Wellington. One million records entered in medication errors database.  Dec 2005 v82 i6 p962(1) AORN Journal , 82, 6. p.962(1). Retrieved from Academic OneFile via Gale: http:// find.galegroup.com.libproxy.chapman.edu / gtx / start.do?prodId = AONE&userGroupName = chap_main Tindale , R. (Dec 2007). Medication errors. Emergency Nurse , 15, 8. p.5(1).  Retrieved, from AcademicOneFile via Gale: http:// find.galegroup.com.libproxy.chapman.edu / gtx / start.do?prodId = AONE&userGroupName = chap_main