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Medication error is a major source of preventable harm to patients in hospitals and is an area in which, it is suggested, information technology will have a positive impact. This paper presents findings from part of a study that examined current information utilisation patterns during nursing medication rounds. Nursing working patterns in medication administration are poorly understood despite being one of the most likely sources of medication error. Methods used were drawn from principles of Human Computer Interaction (HCI), using a semi-structured observational tool for analysing system requirements and data elements. Results from this study indicated that clinical and contextual factors impact on nursing patterns of information handling in many ways, including documentation quality, location of information sources and current patterns of computer utilization. Numerous extraneous interruptions also impact on the ability of nurses to assimilate and use clinical information effectively. These results were used to develop a conceptual framework for interfacing error prevention in clinical practice. These insights into the human factors that are the reality of clinical practice allow us to design and develop effective information technology systems to help prevent nursing medication administration errors.
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