Technologies to improve medication safety in hospitals: A study of their effectiveness and use in Canada

Abstract

Introduction. Adverse drug events (ADEs) caused by medication errors occur regularly in hospitals. Research questions. (1) How effective are in-hospital drug-distribution technologies at improving medication safety? (2) How prevalent are such technologies in Canada's acute-care hospitals? Methods. A systematic review synthesized publications from 1985 to 2002 about the effectiveness of inpatient drug-distribution technologies. A cross-sectional survey of pharmacy directors at Canada's 100 largest acute-care hospitals described technology use, plans for change, and pharmacy-directors' attitudes to technology use and medication error. Results. The systematic review categorized 154 technology comparisons into 23 technology groupings. The evidence consistently favoured the new technologies but its strength was limited. The survey response rate was 78%. Clinical pharmacy services, computerized decision support for pharmacists, and unit-dose system were common; bar-coding and computerized physician order entry were not. Conclusion. This thesis offers a unique compilation of evidence to guide decision-makers in their uptake of technologies intended to improve medication safety.