Schade Charles P, Hannah Karen, Ruddick Patricia, Starling Celesta, Brehm John
West Virginia Medical Institute, Charleston, Wesr Virginia 25304, USA.
Am J Med Qual. 2006 Sep-Oct;21(5):335-41. doi: 10.1177/1062860606291322.
Adverse drug events significantly increase length of stay and costs of hospitalization but are underreported in health care institutions. We hypothesized that hospitals could improve the accuracy of adverse drug event self-reporting by comparing adverse drug events recorded in an occurrence reporting tool with those detected by surveillance of "rescue" drugs administered to treat adverse drug events. We conducted a prospective cohort study of all adult inpatient discharges from a 200-bed rural acute care hospital in West Virginia during a 6-month period. We performed 3572 chart audits, of which 1011 included rescue drug administration. Our outcome measure was the proportion of adverse drug events in the rescue drug surveillance that were found in the occurrence reporting tool. We found that less than 4% of all adverse drug events involving use of rescue drugs were reported. We concluded that underreporting of preventable adverse drug events in this hospital is comparable to published rates and that surveillance of adverse drug events to detect underreporting is feasible.
药物不良事件显著增加住院时间和住院费用，但在医疗机构中报告不足。我们推测，医院可以通过将事件报告工具中记录的药物不良事件与通过监测用于治疗药物不良事件的“解救”药物所检测到的药物不良事件进行比较，来提高药物不良事件自我报告的准确性。我们对西弗吉尼亚州一家拥有200张床位的农村急症医院在6个月期间的所有成年住院患者出院情况进行了一项前瞻性队列研究。我们进行了3572次病历审核，其中1011次涉及解救药物的使用。我们的结果指标是在事件报告工具中发现的解救药物监测中药物不良事件的比例。我们发现，涉及使用解救药物的所有药物不良事件中，报告的不到4%。我们得出结论，该医院可预防药物不良事件的报告不足情况与已公布的发生率相当，并且监测药物不良事件以发现报告不足是可行的。
