Reducing Intravenous Narcotic Documentation Errors On the Electronic Anesthesia Record: A Quality Improvement Project

Abstract

Medication errors are an important public health problem with high human and financial costs. Medication errors in anesthesia can result in patient morbidity or mortality and should be preventable.  Evidence in the literature supports increasing computer access to reduce the number of medication errors. The purpose of this study was to determine if medication errors could be reduced in one university hospital through a clinical intervention of increasing computer access in the post-anesthesia care unit. A quantitative retrospective chart review was conducted. A statistical test of two independent proportions was used to examine the occurrence of schedule II (fentanyl) and IV (midazolam) controlled substance documentation errors before and after increasing computer access in the post-anesthesia care unit. Access to computers appeared to be associated with a reduction of medication errors from 2.3% to 1.5%. The compliance rate increased from 97.6% to 98.5%. The reduction in the error percentage was significant (z = 2.045, p = 0.04). Our findings provide objective evidence for the support of continuous process improvement to reduce medication errors in anesthesia.