Closed Loop Med Admin | The Epma Hub

Closed Loop Medication Administration (CLMA)

What is Closed Loop Medication Administration?

Closed Loop Medication Administration (CLMA) is a digital safety framework designed to ensure that the right patient receives the right medication, at the right dose, via the right route, at the right time. It connects each step of the medicines process, prescribing, dispensing, and administration, using technology to eliminate transcription errors and reduce risk.

In essence, it aims to 'close the loop' by integrating systems and checks at every stage of the medication journey.

Key Components of CLMA

Electronic Prescribing (EPMA)

Medication orders are entered electronically by a prescriber, reducing reliance on handwritten charts.
Doses, routes, and frequencies are standardised and validated within the system.

Pharmacy Verification and Dispensing

Pharmacists clinically check orders within the EPMA system.
Supply requests are generated automatically and sent to pharmacy dispensing systems via HL7 or other interfaces.

Barcode Medication Administration

Nurses scan the patient’s wristband and medication barcode at the bedside.
The system verifies that the drug, dose, and timing match the prescription for that specific patient.

Integration and Real-Time Data

Real-time alerts notify staff of missed doses, early/late administrations, or potential errors.
Integration with EPR's, pharmacy stock systems, and decision support tools enables a seamless process.

Benefits of CLMA

✅ Reduces Medication Errors

Especially those related to transcription, timing, and patient misidentification.

✅ Improves Patient Safety

Real-time alerts, barcode verification, and audit trails enhance quality.

✅ Supports Audit & Compliance

All medication activity is logged and reportable.

✅ Streamlines Workflows

Reduces paperwork and manual cross-checking.

✅ Promotes Accountability

Every action is linked to a user ID and timestamp.

Challenges & Considerations

Technology Integration

Interoperability between EPMA, EPR, dispensing, and barcode systems must be seamless.

Hardware Requirements

Barcode scanners, printers, and mobile devices must be widely available and reliable.

Staff Training & Adoption

Clinical staff must be confident using the system at the bedside.

Workarounds & Bypass Risks

If poorly designed, systems may be bypassed, undermining safety.

Implementation Tips

Start with a detailed workflow analysis

Understand the current state before designing the future state.

Run pilots on selected wards

Identify real-world issues before full rollout.

Provide hands-on training

Focus on nursing and pharmacy staff as frontline users.

Use data to drive improvements

Monitor barcode scan rates, administration compliance, and alert logs.

Summary

Closed Loop Medication Administration is a powerful framework for digitally enhancing medicines safety across the full lifecycle of prescribing, supply, and administration. By closing the loop with integrated systems and real-time checks, healthcare providers can reduce risk, enhance care quality, and create safer workflows for patients and staff alike.

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