Personal digital assistant devices and medication error

Project: Research project

Description

DESCRIPTION: Verbatim from the Applicant?s Abstract
The purpose of this study is to determine the impact of the use of personal
digital assistants (PDAs) by prescribers on potential medication errors in
primary care physicians office-based practices. The specific aims of this
study are to: 1) measure the occurrence of potential preventable medication
related errors in physician office-based practices; 2) assess physicians?
attitudes toward the PDAs to determine issues related to frequency of use,
ease of application to clinical situations, and confidence in the information
obtained from the handheld computer applications related to medications; 3)
identify barriers perceived by M.D.s to PDA use in practice and successful
strategies to overcome these barriers; 4) determine the extent to which the
frequency of potential medication related errors may be reduced by physicians
having improved access to pharmaceutical information needed at the point of
care through the use of personal digital assistant devices (PDAs); and 5)
determine the extent to which the frequency of potential medication related
errors may be reduced by physicians using the PDA as a prescription printing
device in office-based practice. The primary project is a prospective,
randomized, controlled trial of 40 physicians in 40 primary care office-based
practices to observe the impact of PDA use on potential prescriber medication
errors. A baseline potential medication error rate per physician will be
determined for all physicians. The physicians will then be randomized to two
groups: an intervention group and a control group. The intervention involves
training the physicians to use clinical information applications during the
prescribing process through the PDA and entering and printing the
prescriptions to a local printer via the PDA. The control group will conduct
their traditional prescribing practices throughout the study. Prior to
introducing the intervention, an analysis of the human factors and
environmental drivers on site in the physicians? offices will be conducted to
identify barriers to the technology, strategies to overcome these barriers,
and optimal incorporation of the technology and its applications into the
office environment. Instructional design methods will be used to prepare a
practice-based curriculum using case-simulation to teach the physician
prescribers in the intervention group how to engage in and systematically use
this process. A baseline assessment of their anticipated frequency of use,
ease of applications to clinical situations, and confidence in information
obtained will be studied. After use, these measures will be repeated by use
of survey instruments and in-depth interviews. The difference between the
control and intervention group mean potential error rate per physician will be
determined. Bivariate nonparametric statistics will be used to assess the
change in perception of the physicians regarding PDA use as a result of the
intervention. Expected outcomes are 1) to improve provider education to
reduce errors, 2) translate proven effective IT strategies into widespread
practice, and 3) build capacity to further reduce errors. This project will
generate new knowledge that can be used by providers, patients, payers, and
policymakers to determine the contribution of handheld PDAs to reduce medical
errors and improve patient safety in the primary care physician office-based
practice environment.
StatusFinished
Effective start/end date9/30/019/29/05

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health

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Handheld Computers
Medication Errors
Physicians
Equipment and Supplies
Physicians' Offices
Technology
Access to Information
Control Groups
Printing
Primary Care Physicians
Patient Safety
Nonparametric Statistics
Curriculum
Statistical Factor Analysis
Prescriptions
Primary Health Care
Randomized Controlled Trials
Interviews