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BackgroundElectronic prescribing and medication administration (ePMA) is purported to improve patient safety through a number of benefits including reducing medication errors and facilitating identification of prescribers. However little is known of its effect on nurses’ workflow and the associated patient safety implications.Our objective was to explore differences in drug round duration, medication administration workflow and activities, interruptions, and timeliness of medication administration before and after implementation of ePMA.MethodsThe study was an uncontrolled before and after study starting one month before and continuing until one month after implementation of ePMA, in a medicine for the elderly ward in a UK teaching hospital.Observation of nursing staff and documentation of workflow patterns, activities, interruptions and timeliness of medication administration during 20 scheduled drug rounds pre-ePMA and 14 rounds afterwards.ResultsWhile the introduction of ePMA did not significantly affect drug round duration, it altered the distribution of tasks with a doubling of the time spent on documentation. As might be expected, it eliminated time spent searching for paper drug charts. While there was no significant change in interruption rate, the types of interruption changed with an increase in healthcare related interruptions and a decrease in non-healthcare related interruptions. The timeliness of medication administration improved.ConclusionThis small exploratory study suggests that introduction of ePMA does not significantly affect drug round duration, but alters the time spent on different tasks. The timeliness of medication administration improved, with potential benefits to patient safety.

The effect of electronic prescribing and medication administration on nurses’ workflow and activities: an uncontrolled before and after study