Safe chemotherapy (CT) administration and impact on nurses' workflow of a mobile health (mHealth) information technology system

Abstract

Background: A Safe Therapy Mobile (STM) System, fully integrated with the electronic oncological patient record (eOPR), has been developed for the safe delivery of intravenous CT, from prescription to administration and reporting. Material(s) and Method(s): At the moment of the CT prescription, the STM system automatically associates specific barcodes with the patient and each Ct and ancillary drug. At the patient bedside, a barcode reader checks the patient, nurse, infusion bag, drug sequence and time of infusion, in order to monitor and trace the entire administration process, which is then automatically reported in the eOPR. The usability and acceptability of the STM was investigated by means of a modified questionnaire administered to nurses, which explored the three dimensions of the quality of working life, the perceived usefulness and ease of use of the system. The questionnaire was administered to all 15 nurses in both Day Hospitals after each had used the STM system for at least two months. Result(s): In February 2014, STM system was introduced into a Day Hospital with limited daily activities. Two months later, at the end of the testing period, it was adopted for routine chemotherapy administration in the larger Day Hospital of the Medical Oncology Unit of Trento. The STM never failed to match the patient/nurse/ drug sequence/timing association correctly, and proved to be accurate and reliable in tracing and recording the entire administration process. The questionnaires revealed that the users were generally satisfied (86.66%), particularly concerning the perceived usefulness of the system when managing therapy administration (86.66%), the improvement in information sharing (93,33%) and the general perception of greater safety when administering the therapies (86.66%). The system was perceived as helping to associate the prescribed drugs with the right patient (73.33%) and respect the correct sequence of administration (93.33%), speeding up recording the details of the administered therapies in the eOPR (80%), although it appeared to slow down bedside operations (60%). No significant objective differences in the duration of CT administration however were found after the system was introduced. Conclusion(s): It appears from these data that the STM system may effectively ensure a safer in-hospital delivery of infusion chemotherapy with a positive impact on nurses' work flow.