NRS 493 Capstone Project Change Adverse Drug Reaction

Nrs 49306072022capstone Project Change Adverse Drug Reactions Among

Designing an effective intervention to reduce adverse drug reactions (ADRs), particularly among older adults, is vital due to the significant health and economic consequences associated with these events. This project aims to examine the implementation of electronic medication systems as a strategic solution to improve medication safety, optimize workflows, and reduce healthcare costs related to ADRs.

Adverse drug reactions result in approximately 1.3 million emergency visits annually, with older adults aged 65 and above at higher risk due to factors such as polypharmacy, cognitive impairment, and sensory deficits (Gurwitz et al., 2014). These reactions can lead to extended hospital stays, readmissions, increased healthcare costs, and compromised patient safety (Wang et al., 2018). Addressing this challenge requires deploying evidence-based interventions that promote safer medication practices.

The project focuses on adopting electronic medication systems that automatically document medication administration through electronic health records (EHR) and tracking sensors. Literature supports the benefits of electronic medication, including reducing medication errors, enhancing workflow efficiency, and improving patient safety outcomes (Li et al., 2019; Gregory et al., 2021). Among the approaches considered—educational training for practitioners and patients versus electronic medication—the latter has shown to be more effective in streamlining medication management and decreasing ADRs (Li et al., 2019).

Paper For Above instruction

Introduction

Adverse drug reactions (ADRs) pose a significant challenge within healthcare systems worldwide, particularly impacting vulnerable populations such as older adults. These reactions not only threaten patient safety but also impose substantial financial burdens on healthcare facilities. With approximately 1.3 million emergency visits annually attributed to ADRs, and a notably higher prevalence among individuals aged 65 years and older, healthcare providers are compelled to explore innovative interventions to mitigate these risks (Gurwitz et al., 2014). This paper evaluates the implementation of electronic medication systems as a strategic measure to reduce ADRs, streamline workflows, enhance patient safety, and decrease healthcare costs.

Background and Significance

The elderly population is especially susceptible to ADRs due to multiple factors including polypharmacy, age-related physiological changes, cognitive impairments, and sensory deficits (Gurwitz et al., 2014). These factors complicate medication management and increase the likelihood of errors such as incorrect dosages and drug interactions. The negative repercussions extend beyond individual health, impacting hospital operations and escalating costs through longer length of stays (LOS) and higher readmission rates. Therefore, deploying effective interventions is essential for improving clinical outcomes and operational efficiency.

Intervention Strategies

Literature suggests two primary interventions: educational training for healthcare providers and patients, and the integration of electronic medication systems. While education can increase awareness and knowledge about medication safety, evidence indicates that electronic medication systems offer a more robust, real-time approach by automatically documenting drug administration and providing alerts for potential errors (Li et al., 2019). Consequently, this project advocates for the adoption of electronic medication management systems that leverage EHR technology along with electronic tracking sensors to enhance safety and workflow.

Evidence-Based Literature

A comprehensive literature review was performed using Google Scholar and PubMed, selecting articles published within the past five years. Key search terms included "electronic medication" and "Adverse Drug Events," combined with Boolean operators to narrow results. Findings consistently demonstrate that electronic medication solutions reduce medication errors, improve workflow efficiencies, and bolster patient safety (Gregory et al., 2021; Li et al., 2019; Wang et al., 2018).

Gregory et al. (2021) reported that electronic medication administration systems decrease nurses' time spent on documentation, allowing more direct patient care, although further research is warranted to assess long-term impact. Li et al. (2019) found that electronic medication systems outperform traditional approaches when combined with education, significantly reducing ADRs. Patients also express greater confidence and satisfaction with electronic prescribing systems, indicating high acceptance levels (Lau et al., 2018). Overall, the evidence supports the integration of electronic medication systems as a means to enhance safety, accuracy, and efficiency.

Change Objectives

The primary goals of this project are to improve clinical workflows, increase patient safety, and minimize healthcare costs. Specifically:

• Enhance workflow efficiency by automating medication documentation (Kinlay et al., 2021)
• Improve patient safety by reducing medication errors and adverse reactions (Wang et al., 2018)
• Reduce overall healthcare expenditure through fewer readmissions and shorter LOS (Bugnon et al., 2021)
• Advance clinical best practices in medication management

These objectives align with best practices from current literature, emphasizing the importance of electronic systems in optimizing healthcare delivery.

Resources Necessary for Implementation

Effective deployment requires specific technological and human resources, including:

• Digital displays, audiovisual reminders, real-time monitors, and recording tools (Checchi et al., 2014)
• Trained healthcare personnel capable of operating and maintaining electronic medication systems
• Robust Electronic Health Record (EHR) database infrastructure
• Compliance with standards that include recording dosing events, storing adherence records, providing reminders, and offering feedback to patients (Checchi et al., 2014)

Expected Outcomes

Implementing electronic medication management is anticipated to yield multiple benefits, including:

• Reduced hospital readmissions related to medication errors
• Shortened LOS for targeted patient populations
• Lower operational and treatment costs
• Enhanced patient safety and reduced infection risks
• Diminished outpatient visits and emergency care instances

Evaluation will be conducted through outcome measures such as patient and practitioner interviews, hospital record audits, and quasi-experimental comparisons of healthcare expenditures. Success will be determined by achieving the set change objectives, notably reduced ADR occurrence, improved workflow, and cost savings.

Conclusion

The integration of electronic medication systems offers a promising avenue for reducing adverse drug reactions among older adults and overall patient populations. Supported by current research, these systems enhance safety, operational efficiency, and cost-effectiveness. Future efforts should focus on addressing implementation barriers, staff training, and continuous monitoring to maximize benefits and sustain improvements in medication safety.

References

• Bugnon, B., Geissbuhler, A., Bischoff, T., Bonnabry, P., & von Plessen, C. (2021). Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study. JMIR Formative Research, 5(1).
• Checchi, K. D., Huybrechts, K. F., Avorn, J., & Kesselheim, A. S. (2014). Electronic medication packaging devices and medication adherence. JAMA, 312(12), 1237.
• Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive Care Nurses' experiences with the new electronic medication administration record. Nursing Open, 9(3), 1895–1901.
• Kinlay, M., Ho, L. M., Zheng, W. Y., Burke, R., Juraskova, I., Moles, R., & Baysari, M. (2021). Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow. Applied Clinical Informatics, 12(05), 1049–1060.
• Lau, G., Ho, J., Lin, S., Yeoh, K., Wan, T., & Hodgkinson, M. (2018). Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network. Health Information Management Journal, 48(1), 12–23.
• Li, R., Zaidi, S. T., Chen, T., & Castelino, R. (2019). Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review. Pharmacoepidemiology and Drug Safety, 29(1), 1–8.
• Wang, H., Meng, L., Song, J., Yang, J., Li, J., & Qiu, F. (2018). Electronic medication reconciliation in hospitals: A systematic review and meta-analysis. European Journal of Hospital Pharmacy, 25(5), 245–250.