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Remote Order Entry and Video Verification: Reducing After-Hours Medication Errors in a Rural Hospital

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Abstract:

Background: Hendry Regional Medical Center, a 66bed facility, has 8.5 hours of pharmacy staffing daily. Review of two years of medication errors indicated that 34% of all medication errors involved selection of the wrong drug from stock after pharmacy hours.

Process Changes: During 2003 many changes were implemented in the medication management process to enhance medication safety. For example, a limited-access area of the pharmacy was established for night entry by the nursing supervisor. The hospital then implemented services with a newly licensed remote order-entry service. These steps decreased the rate of errors involving wrong drug selection to 15%. Subsequently, a medication error involving selection of the wrong drug at night prompted another look at the process.

Implementing the Video Verification Process: The hospital began using a webcam to create a digital image of the medication selected for removal from the pharmacy stock by the nursing supervisor. This image is transmitted via e-mail. In six months, only one (recent) error resulting from selection of the wrong medication after normal pharmacy hours occurred; the medication selection process simply was not followed.

Discussion: Results of medication error reporting indicated that using Webcam/e-mail image transmission and video verification by a pharmacist further improved patient safety in the medication selection process.

Document Type: Research Article

Publication date: 2004-08-01

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  • The Joint Commission Journal on Quality and Patient Safety will be published by Elsevier beginning in 2017! For readers who receive access to the journal through their institutions, the journal can now be found on ScienceDirect (http://www.sciencedirect.com/science/journal/15537250). For librarians looking to subscribe to the journal for their institutions please contact your Elsevier Account Manager or visit www.myelsevier.com for more information. All other readers, please visit http://www.jointcommissionjournal.com/ to subscribe to the journal or to claim your access for an existing subscription.
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