Personal digital assistant devices and medication error

个人数字助理设备和用药错误

• 批准号: 6448717
• 负责人: KIMBERLY A GALT
• 金额: $ 34.53万
• 依托单位: CREIGHTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2004-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6448717
• 关键词: clinical research; clinical trials; computer human interaction; health care personnel performance; health service demonstration project; human subject; patient safety /medical error; personal computers; primary care physician

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.

描述：申请人摘要的逐字 这项研究的目的是确定个人使用的影响 处方者关于潜在用药错误的数字助手（PDA） 初级保健医生基于办公室的实践。这个特定的目的 研究是：1）测量潜在可预防药物的发生 基于办公室的实践中的相关错误； 2）评估医生？ 对PDA的态度，以确定与使用频率有关的问题， 易于临床情况的应用和对信息的信心 从与药物有关的手持计算机应用中获得； 3） 确定医学博士在实践中使用PDA使用的障碍 克服这些障碍的策略； 4）确定 医生可能会降低潜在药物相关错误的频率 改善了在需要的药物信息时所需的药物信息 通过使用个人数字助理设备（PDA）来照顾； 5） 确定潜在药物频率相关的程度 使用PDA作为处方打印的医生可能会减少错误 基于办公室的练习中的设备。主要项目是一个潜在的 40位初级保健办公室的40位医生的随机对照试验 观察PDA使用对潜在处方药物的影响的实践 错误。每个医师的基线潜在药物错误率将是 为所有医生确定。然后，医生将被随机分为两个 组：干预组和对照组。干预涉及 培训医生在期间使用临床信息应用 通过PDA处方过程，并输入和打印 通过PDA向本地打印机的处方。对照组将进行 他们在整个研究过程中的传统处方实践。之前 引入干预措施，分析人为因素和 医生现场的环境驱动程序？办公室将进行 确定技术的障碍，克服这些障碍的策略， 以及该技术及其应用的最佳纳入 办公环境。教学设计方法将用于准备 基于练习的课程使用病例模拟教医生 干预小组的处方者如何进行和系统地使用 这个过程。对其预期使用频率的基线评估， 易于临床情况的申请和对信息的信心 将研究获得的。使用后，这些措施将通过使用重复 调查工具和深入的访谈。在 控制和干预组平均每个医师的潜在错误率将是 决定。双变量非参数统计将用于评估 医生关于PDA使用的感知变化。 干涉。预期的结果是1）改善提供商教育 减少错误，2）将有效的IT策略转化为广泛的 练习和3）建立进一步减少错误的能力。这个项目将 产生新知识，提供者，患者，付款人以及 决策者确定手持PDA对减少医疗的贡献 错误并改善基于初级保健医师办公室的患者安全 练习环境。