1
Review: Use of a handheld computer
application for voluntary medication event
reporting by inpatient nurses and physicians
D. AlHuwail, Mobile Medical Computing Scholar

Summary — For enhancing hospital safety monitoring, can
handheld tools assist in reporting voluntary medication event
reports at inpatient wards? This study found that handheld-
based reporting tools offer better recording of potential Adverse
Drug Events (ADE) than traditional safety monitoring systems.
They offer convenience, mobility, privacy, and point-of-care
reporting. These tools may complement hospital safety
monitoring systems for safer patient care.
Keywords — Handhelds, Monitoring, ADE
I. RESEARCH DESIGN/METHODOLOGY
TYPE: Controlled trial
VALIDITY: Potential bias due to the participant
recruitment process - as noted by authors. The clinicians who
participated in the study did so on a voluntary basis, which
may suggest prior experience or preference for using
handhelds and handheld-based reporting tools. No data was
collected from clinicians who choose not to participate in the
study.
ENVIRONMENT: Inpatient medical wards at four
university-affiliated teaching hospitals.
II. RESEARCH QUESTION
For enhancing hospital safety monitoring, can handheld
tools assist in reporting voluntary medication event reports at
inpatient wards?
III. PATIENT/PROBLEM/POPULATION DEFINITION
PROBLEM: Underreporting of inpatient medication events.
POPULATION: Resident physicians, attending physicians,
and nurses.
TYPE: Clinical research.
D. AlHuwail is a software engineer with the Information Systems
Department at the Ministry of Health in Kuwait and an IEEE member.
(d.alhuwail@moh.gov.kw).
IV. INTERVENTION
PDA with a handheld Medication Event Reporting Tool
(MERT) for medication reporting at inpatient medical wards.
Collected data included user identification, time stamp, type
and severity of the incident, and the stage at which the incident
was reported.
MERT is a custom application coded in Visual Basic and
built on an AppForg platform. It was loaded and operated on
Palm Zire™ 21 handheld computers. Via a hotsync conduit, all
data collected from participants were uploaded to a centralized
server database on a weekly basis for the duration of the study.
V. COMPARISON
 Physicians and nurses were recruited to carry the
MERT-installed handhelds for a one-week interval.
Participants had the opportunity to participate in
more than one interval as long as the hospital's
staffing assignments permitted them to do so.
 Demographics, professional experience, and education
level data were collected by the software through the
initial sign-in process.
 At the beginning of each shift, daily workload
information was collected. Randomly and in a
repetitive manner throughout the day, participants'
ecological work dynamics - such as work activity and
stress - were also surveyed and reported separately.
 MERT could be launched at any given moment the
participant desired.
 Statistical calculations were performed using SPSS
version 12.0. Statistical comparisons were completed
as 2-tailed tests, using an alpha level of 0.05 for
determining significance. Student's t-tests and chi-
square test of proportions were also performed.
VI. OUTCOME
Sixty-nine percent of potential Adverse Drug Events
(ADEs) were recorded by the tool prior to administration of
medication, while 27% of the events resulted in no perceptible
injury to the patient after medication administration. The tool
 2

has surpassed other monitoring systems, like MEDMARX ® -

an online database of medication and adverse drug reactions -
that captured only 35% of potential ADEs.

VII. APPLICATION OF RESULTS TO PATIENT CARE

The results of this study support that MERT-enabled
handhelds may help healthcare providers augment their
hospital safety monitoring systems to prevent adverse drug
reactions and to offer a safer healthcare delivery environment.

VIII. FURTHER AREAS FOR RESEARCH

Examine the scalability and integration of handheld tools for
complementing hospital event reporting systems. Future
studies of deploying MERT-enabled handhelds are needed in
order to examine if such tools are scalable and sustainable
while improving medication incident detection in clinical
practice.

ACKNOWLEDGMENT
D. AlHuwail thanks Dr. Mohammad Al-Ubaydli and Jeffery
Loo for their support and effort.

CITATION

AlHuwail D. 2009 Mar. Review of: Use of handheld computer

application for voluntary medication event reporting by inpatient
nurses and physicians. Mobile medical computing reviews. [Online].

REFERENCES
[1] Dollarhide AW, Rutledge T, Weinger MB, Dresselhaus TR., Use of
handheld computer application for voluntary medication event
reporting by inpatient nurses and physicians. J Gen Intern Med. 2008
Apr;23(4):418-22.

D.AlHuwail is a software engineer at the Information Systems Department at

the Ministry of Health in Kuwait. Mr. AlHuwail earned his Bachelors of
Science of Science in Management Information Systems (with Honors),
Entrepreneurship (with Honors), and Operations Management from the
University of Arizona, Tucson, Arizona, USA in 2006. Mr. AlHuwail also
earned his Masters of Science (with Honors) in Management Information
Systems - concentration on Biomedical and Health Informatics - from the
University of Arizona, Tucson, Arizona, USA in 2007.

Mr. AlHuwail is a member of IEEE, Kuwait Health Initiative, and Kuwait

Information Technology Society (membership pending).