Journal article
Implementation of distributed automated medication dispensing units in a new hospital: Nursing and pharmacy experience
Journal of Clinical Nursing, Vol.30(19-20), pp.2863-2872
10/2021
PMID: 33931903
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Source: InCites
Abstract
Aims and objectives: To explore the structures, processes and outcomes involved in an Automated Medication Dispensing system implementation and its impact on patient safety.
Background: Increasing digitalisation of medication prescribing, dispensing, administration and stock management has occurred over the past two decades. While automated medication dispensing units aim to provide safe, high‐quality, patient‐centred care, the implementation may result in unintended consequences leading to suboptimal outcomes.
Design: This study uses a qualitative approach guided by Donabedian's structure, process and outcome framework.
Methods: Twenty‐six registered nurses and pharmacy assistant staff, from clinical areas equipped with automated medication dispensing cabinets, participated in semi‐structured interviews. In‐depth, thematic analysis explored the structures and processes. Together with interview data, content analysis of text data generated by internal risk management and critical incident reporting systems was undertaken to evaluate outcomes. Findings were considered in light of the Interactive Sociotechnical Analysis approach to health information technology. The COREQ checklist was used in preparation of this article.
Results: Pharmacy assistants reported better satisfaction with the system at implementation than nurses. Training provided for nurses and their involvement in system implementation was reported as insufficient; however, nurses’ use of and satisfaction with the system improved over time. A recursive relationship between the changes imposed by the system and nurses’ creative problem solving (workarounds) used to manage these changes, impacted work productivity for nurses and safety for patients.
Conclusions: The individualised nature of “workarounds” employed offered both risks and opportunities which require further identification, investigation and management.
Relevance to clinical practice: Nurses are the majority of the health workforce. Digitalisation of traditionally paper‐based activities in health care, impacting nursing work, requires similar strategies to any practice change.
Details
- Title
- Implementation of distributed automated medication dispensing units in a new hospital: Nursing and pharmacy experience
- Creators
- Alison Craswell - University of the Sunshine CoastKate Bennett - Sunshine Coast University HospitalJulie Hanson - University of the Sunshine CoastBrett Dalgliesh - Sunshine Coast University HospitalMarianne Wallis - Southern Cross University
- Publication Details
- Journal of Clinical Nursing, Vol.30(19-20), pp.2863-2872
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Number of pages
- 10
- Grant note
- This study was funded by a grant from BD, the manufacturers of Pyxis Med Station; however, they had no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication
- Identifiers
- 991012970570602368
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article