ArticleBMJ health & care informatics2020
Changes in medication administration error rates associated with the introduction of electronic medication systems in hospitals: a multisite controlled before and after study.
Article in BMJ health & care informatics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Assessing the Effectiveness of Interventions Implemented by Nurses to Reduce Medication Administration Errors in Hospitalised Acute Adult Patient Settings: Systematic Review and Meta-Analysis.Journal of clinical nursing · 2026Pooled it
- Effectiveness of non-interruptive nudge interventions in electronic health records to improve the delivery of care in hospitals: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2023Pooled it
- Observational
- Unpopular patients and compassion fatigue among nurses: a mixed-methods study on emotional burden, workforce well-being, and patient safety.BMC nursing · 2026Article
- Understanding limited effectiveness of a set of interventions implemented under continuous quality improvement methodology: a process assessment informed by MRC guidance.Frontiers in health services · 2026Article
- Impact of smart and digital transformation on pharmacy intravenous admixture services in a tertiary-grade A hospital.Frontiers in pharmacology · 2026Article
- Effect of nurse informatics on medication errors, patients' satisfaction, and quality patient care - A systematic review and metanalysis.Journal of education and health promotion · 2026Review
- Changes in Medication Errors after Implementation of an Electronic Health Record System in a Canadian Community Hospital.The Canadian journal of hospital pharmacy · 2026Article
- Article
- Evaluating the efficacy of the new electronic dental assistant training program.Scientific reports · 2025Article
- Analysis of Drug Product Dispensing Error Characteristics, Construction and Evaluation of a Risk Warning Model in Outpatient Pharmacy: A Retrospective Study in China.Risk management and healthcare policy · 2025Article
- Errors Associated With Medication Administration by a Nurse During Hospitalisation: A Prospective Observational Multicentric Study.Nursing open · 2025Observational
- Understanding prescribing errors for system optimisation: the technology-related error mechanism classification.BMJ health & care informatics · 2024Article
- TeamSTEPPS improves patient safety.BMJ open quality · 2024Article
- Methods for studying medication safety following electronic health record implementation in acute care: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Effect of a closed-loop medication order executive system on safe medication administration at a tertiary hospital: a quasi-experimental study.Therapeutic advances in drug safety · 2024Article
- Prevalence and determinants of medication administration errors in clinical wards: A two-centre prospective observational study.Journal of clinical nursing · 2023Observational
- A Novel Use of Bar Code Medication Administration Data to Assess Nurse Staffing and Workload.Applied clinical informatics · 2023Article
- The impact of drug error reduction software on preventing harmful adverse drug events in England: a retrospective database study.BMJ open quality · 2022Article
- Effect of automated unit dose dispensing with barcode scanning on medication administration errors: an uncontrolled before-and-after study.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElectronic medication systems (EMS) have been highly effective in reducing prescribing errors, but little research has investigated their effects on medication administration errors (MAEs).
objectiveTo assess changes in MAE rates and types associated with EMS implementation.
methodsThis was a controlled before and after study (three intervention and three control wards) at two adult teaching hospitals. Intervention wards used an EMS with no bar-coding. Independent, trained observers shadowed nurses and recorded medications administered and compliance with 10 safety procedures. Observational data were compared against medication charts to identify errors (eg, wrong dose). Potential error severity was classified on a 5-point scale, with those scoring ≥3 identified as serious. Changes in MAE rates preintervention and postintervention by study group, accounting for differences at baseline, were calculated.
results7451 administrations were observed (4176 pre-EMS and 3275 post-EMS). At baseline, 30.2% of administrations contained ≥1 MAE, with wrong intravenous rate, timing, volume and dose the most frequent. Post-EMS, MAEs decreased on intervention wards relative to control wards by 4.2 errors per 100 administrations (95% CI 0.2 to 8.3; p=0.04). Wrong timing errors alone decreased by 3.4 per 100 administrations (95% CI 0.01 to 6.7; p<0.05). EMS use was associated with an absolute decline in potentially serious MAEs by 2.4% (95% CI 0.8 to 3.9; p=0.003), a 56% reduction in the proportion of potentially serious MAEs. At baseline, 74.1% of administrations were non-compliant with ≥1 of 10 procedures and this rate did not significantly improve post-EMS.
conclusionsImplementation of EMS was associated with a modest, but significant, reduction in overall MAE rate, but halved the proportion of MAEs rated as potentially serious.
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