DESIGN AND USABILITY TESTING OF A NEAR FIELD COMMUNICATION-BASED BEDSIDE MEDICATION ADMINISTRATION AND CLINICAL COMMUNICATION SYSTEM

Abstract

Medication administration errors are a critical issue that can lead to significant clinical consequences. In nursing practice, the three major causes of medication errors in the administration stage are failure to confirm the ‘five rights’ of medication administration, failure to verify contraindications, and failure to effectively communicate with other healthcare providers. The purpose of this research is to design a prototype NFC-based Medication Administration and Clinical Communication (NFC-MACC) system to reduce the medication errors and streamline the processes of bedside medication administration, and to understand nurses’ perception regarding its usability. NFC (Near Field Communication) is an effective short-range wireless technology that has been used to securely identify objects. While many healthcare domains have benefited from the use of NFC, it is currently in limited use in bedside medication administration in hospitals. The research study is divided into three sequential phases. The first phase is a preliminary study, in which we apply a mixed-method approach and aim to explore whether the idea of using an NFC technology is acceptable and usable for nurses during the medication administration stage. We test the usability of an initial prototype design of two functions of the NFC-MACC system, namely, to verify drug allergy and to verify drug interactions. The findings indicate positive feedback concerning the usability and acceptance of the NFC technology, and provide recommendations for improvements. The recommendations are then used as design guidelines for the NFC-MACC system. The second phase uses a descriptive qualitative approach and aims to understand the bedside medication administration procedure to help us in designing the system. The findings provide us a better understanding of the required data and sources used in nursing practice to verify medications and to contact healthcare providers, and assisted us to define the essential functional guidelines for the NFC-MACC system. The design and functional guidelines obtained from Phase 1 and Phase 2 were utilized to design the prototype NFC-MACC system. We designed the system to reduce the major causes of medication errors by: (1) identifying the patient and the medication; (2) confirming the five rights of medication administration; (3) verifying allergies; (4) verifying drug interactions; (5) verifying contraindications; (6) alerting nurses and providing sufficient alert information; (7) providing real-time communication between nurses and other healthcare providers; and (8) documenting the administered medication. The third phase aims to understand the nurses’ perception regarding the usability of the NFC-MACC system. A mixed-method approach to test the usability of the system is employed. The findings show that the system was well received by the nurses and offers promise to ease the steps required to verify medications and improve clinical communication efficiency and mobility. Overall, this thesis presents a comprehensive research study that emphasizes the use of NFC technology at the bedside medication administration stage. Evidence derived from user studies of nurses shows the benefits of NFC technology over the existing wireless medication administration systems. Participants expressed their interest in using the NFC-MACC system in a clinical setting and believed it would enhance nursing practice and increase patient safety.