Validation of a mobile app for reducing errors of administration of medications in an emergency

Abstract

Medication errors occur frequently and are a risk to patient safety. To reduce mistakes in the medication process in emergencies, a mobile app has been developed supporting the calculation of doses and administration of drugs. A simulation study was performed to validate the app as a tool to reduce medication errors. This was a randomised crossover study conducted in the Academic Hospital. The participants included were residents and attendings in anaesthesiology. 74 Participants performed four simulation scenarios in which they had to calculate and administer drugs for emergencies. Two scenarios were performed with the app (“app scenarios”) and the other two scenarios were performed without the use of the app (“control scenarios”). The order of drugs, simulation patients and usage of aid were randomized. The accuracy of administered drug doses were measured. Medications were categorised as either “accurate” ($\pm 20$% of target dosage) or “wrong” (less than 50% or more than 200% of target dosage). The dosage calculated and the dosage administered were documented separately to differentiate between calculation and handling errors. During app scenarios, there were no “wrong” dosages, whereas 6.8 (95% CI 2.7–10.8%) of dosages in control scenarios were evaluated as “wrong”. The probability of giving an “accurate” dosage was increased from 77.7 (70.9–84.5%) in control scenarios to 93.9 (90–97.8%) in app scenarios. Calculation errors were the main cause for wrong dosing. The app is an appropriate and feasible tool to reduce calculation and handling errors and may increase patient safety.

Appendix

See Table 2.

Table 2 Overview of cases and frequency during the study