Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Myoung Soo Kim

doi:10.7475/kjan.2014.26.3.253

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Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Myoung Soo Kim

Korean Journal of Adult Nursing 2014;26(3):253-265.
Published online: June 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.3.253

Department of Nursing, Pukyong National University, Busan, Korea

Corresponding author: Kim, Myoung Soo Department of Nursing, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan 608-737, Korea. Tel: +82-51-629-5782, Fax: +82-51-629-7906, E-mail: kanosa@pknu.ac.kr

This work was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education, Science and Technology(2011-00133252)

• Received: October 27, 2013 • Accepted: May 30, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications.
Methods
A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysisx²-test and t-test for the homogeneity of participants and a paired t-test for effectiveness in each group with the SPSS 18.0.
Results
Stability of medication administration was estimated by knowledge and certainty ranged from a score of one to three. A correct answer with high certainty was coded as high stability low certainty regardless of correct answer was coded as a moderate stability and incorrect answers with high certainty were rated as low stability. There were no differences in ‘ knowledge of high alert medication “Certainty of knowledge” stability of medication administration “confidence of single checking medication” and “medication safety activities” between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in ‘ certainty of medication knowledge’ (t=3.51p=.001) than the comparison group.
Conclusion
Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.
Key Words: Decision support system; Medication reconciliation; Medication error; Single checking; Patient safety

Figure 1.

Templates of developed application.

Figure 2.

Example of developed smartphone-based Precise Drug Dosage Calculation Application.

Table 1.

Homogeneity Test of Study Variables at the Baseline (N=59)

Variables (No. of items)	Variables	Total	Exp. (n=33)	Cont. (n=26)	x² or t (p)
Variables (No. of items)	Variables	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t (p)
Age (year)	23~25	28 (47.5)	13 (39.4)	15 (46.4)	1.95 (.196)
	≥26	31 (52.5)	20 (60.6)	11 (64.5)
	M±SD	26.53±3.16	27.12±3.74	25.77±2.05	1.77 (.083)
Marital status	Married	5 (8.5)	3 (9.1)	2 (7.7)	0.04 (1.000)
Marital status	Single	54 (91.5)	30 (90.9)	24 (92.3)
Education	College	7 (11.9)	3 (9.1)	4 (15.4)	0.55 (.688)
Education	Bachelor	52 (88.1)	30 (90.9)	22 (84.6)
Total nursing experience (year)	≤3	24 (40.7)	14 (42.4)	10 (38.5)	0.10 (.795)
	＞3	35 (59.3)	19 (57.6)	16 (61.5)
	M±SD (month)	44.10±28.78	48.15±35.76	38.94±15.35	1.33 (.190)
Position^†	Charge nurse	3 (5.1)	2 (6.1)	1 (3.8)	0.15 (1.000)
Position^†	Staff nurse	56 (94.9)	31 (93.9)	25 (96.2)
Knowledge of high alert medication (20)		0.71±0.11	0.68±0.10	0.74±0.10	2.30 (.025)
Certainty of knowledge (20)		2.71±0.61	2.63±0.52	2.80±0.71	1.05 (.297)
Stability of medication administration (20)		0.91±0.63	0.77±0.56	1.09±0.69	1.97 (.054)
Confidence for single checking medication (14)		3.33±0.51	3.34±0.55	3.31±0.44	-0.23 (.817)
Medication safety activities (9)		4.20±0.42	4.13±0.43	4.29±0.38	1.55 (.127)

Exp.=experimental group; Cont.=control group.

^†Fisher's exact test.

Table 2.

Changes of Study Variables between Pre-post Stages in Each Group

Variables	Exp. (n=33)		t (p)	Cont. (n=26)		t (p)	Difference of Post-Pre		t (p)
	Pre	Post		Pre	Post		Exp.	Cont.
	M±SD	M±SD		M±SD	M±SD		M±SD	M±SD
Knowledge of high alert medication	0.68±0.10	0.69±0.12	0.55	0.74±0.10	0.75±0.09	0.60	0.01±0.11	0.01±0.10	-0.03
Knowledge of high alert medication			(.584)			(.555)			(.973)
Certainty of knowledge	2.63±0.52	2.96±0.47	3.51	2.80±0.71	2.97±0.64	1.27	0.32±0.53	0.17±0.68	0.97
Certainty of knowledge			(.001)			(.218)			(.334)
Stability of medication administration	2.16±0.25	2.25±0.28	1.58	2.33±0.27	2.39±0.26	1.29	0.09±0.31	0.07±0.26	0.27
Stability of medication administration			(.125)			(.210)			(.785)
Confidence for single checking medication	3.34±0.55	3.39±0.54	0.60	3.31±0.44	3.37±0.42	0.58	0.04±0.41	0.05±0.46	-0.08
Confidence for single checking medication			(.552)			(.570)			(.938)
Medication safety activities	4.13±0.43	4.23±0.43	1.43	4.29±0.38	4.24±0.45	-0.63	0.10±0.39	-0.05±0.42	1.40
Medication safety activities			(.163)			(.535)			(.164)
Number of daily use	7.77±±5.90
Frequency of use	28.29±20.84
Program satisfaction	3.00±0.95

Exp.=experimental group; Cont.=control group.

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Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Korean J Adult Nurs. 2014;26(3):253-265. Published online June 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.3.253

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Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Korean J Adult Nurs. 2014;26(3):253-265. Published online June 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.3.253

Figure

Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Figure 1. Templates of developed application.

Figure 2. Example of developed smartphone-based Precise Drug Dosage Calculation Application.

Figure 1.

Figure 2.

Development and Effectiveness of Smartphone Application for the Medication Confirmation of High-alert Medications

Table 1.

Homogeneity Test of Study Variables at the Baseline (N=59)

Variables (No. of items)	Variables	Total	Exp. (n=33)	Cont. (n=26)	x² or t (p)
Variables (No. of items)	Variables	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t (p)
Age (year)	23~25	28 (47.5)	13 (39.4)	15 (46.4)	1.95 (.196)
	≥26	31 (52.5)	20 (60.6)	11 (64.5)
	M±SD	26.53±3.16	27.12±3.74	25.77±2.05	1.77 (.083)
Marital status	Married	5 (8.5)	3 (9.1)	2 (7.7)	0.04 (1.000)
Marital status	Single	54 (91.5)	30 (90.9)	24 (92.3)
Education	College	7 (11.9)	3 (9.1)	4 (15.4)	0.55 (.688)
Education	Bachelor	52 (88.1)	30 (90.9)	22 (84.6)
Total nursing experience (year)	≤3	24 (40.7)	14 (42.4)	10 (38.5)	0.10 (.795)
	＞3	35 (59.3)	19 (57.6)	16 (61.5)
	M±SD (month)	44.10±28.78	48.15±35.76	38.94±15.35	1.33 (.190)
Position^†	Charge nurse	3 (5.1)	2 (6.1)	1 (3.8)	0.15 (1.000)
Position^†	Staff nurse	56 (94.9)	31 (93.9)	25 (96.2)
Knowledge of high alert medication (20)		0.71±0.11	0.68±0.10	0.74±0.10	2.30 (.025)
Certainty of knowledge (20)		2.71±0.61	2.63±0.52	2.80±0.71	1.05 (.297)
Stability of medication administration (20)		0.91±0.63	0.77±0.56	1.09±0.69	1.97 (.054)
Confidence for single checking medication (14)		3.33±0.51	3.34±0.55	3.31±0.44	-0.23 (.817)
Medication safety activities (9)		4.20±0.42	4.13±0.43	4.29±0.38	1.55 (.127)

Exp.=experimental group; Cont.=control group.

^†Fisher's exact test.

Table 2.

Changes of Study Variables between Pre-post Stages in Each Group

Variables	Exp. (n=33)		t (p)	Cont. (n=26)		t (p)	Difference of Post-Pre		t (p)
	Pre	Post		Pre	Post		Exp.	Cont.
	M±SD	M±SD		M±SD	M±SD		M±SD	M±SD
Knowledge of high alert medication	0.68±0.10	0.69±0.12	0.55	0.74±0.10	0.75±0.09	0.60	0.01±0.11	0.01±0.10	-0.03
Knowledge of high alert medication			(.584)			(.555)			(.973)
Certainty of knowledge	2.63±0.52	2.96±0.47	3.51	2.80±0.71	2.97±0.64	1.27	0.32±0.53	0.17±0.68	0.97
Certainty of knowledge			(.001)			(.218)			(.334)
Stability of medication administration	2.16±0.25	2.25±0.28	1.58	2.33±0.27	2.39±0.26	1.29	0.09±0.31	0.07±0.26	0.27
Stability of medication administration			(.125)			(.210)			(.785)
Confidence for single checking medication	3.34±0.55	3.39±0.54	0.60	3.31±0.44	3.37±0.42	0.58	0.04±0.41	0.05±0.46	-0.08
Confidence for single checking medication			(.552)			(.570)			(.938)
Medication safety activities	4.13±0.43	4.23±0.43	1.43	4.29±0.38	4.24±0.45	-0.63	0.10±0.39	-0.05±0.42	1.40
Medication safety activities			(.163)			(.535)			(.164)
Number of daily use	7.77±±5.90
Frequency of use	28.29±20.84
Program satisfaction	3.00±0.95

Exp.=experimental group; Cont.=control group.

Table 1. Homogeneity Test of Study Variables at the Baseline (N=59)

Exp.=experimental group; Cont.=control group.

†

Fisher's exact test.

Table 2. Changes of Study Variables between Pre-post Stages in Each Group

Exp.=experimental group; Cont.=control group.

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