Peeters Michael J, Pinto Sharrel L
University of Toledo College of Pharmacy, Toledo, Ohio 43606, USA.
J Hosp Med. 2009 Feb;4(2):97-101. doi: 10.1002/jhm.387.
Several complex and costly interventions reduce medication errors. Little exists on the effectiveness of providing education and feedback to institutional clinicians as a means of reducing errors.
To determine the impact on prescribing errors of a pharmacist-led educational intervention.
Prospective, interrupted time series study.
This study was conducted among internal medicine residents at the 320-bed University of Toledo Medical Center.
The educational intervention was conducted during a 6-month period beginning in November 2006. The intervention included an initial hour-long lecture followed by biweekly and then monthly discussions that used timely, institution-specific examples of prescribing errors.
Data were collected at 5 time points: month 0 (preintervention period); months 1, 3, and 6 (intervention period); and month 7 (postintervention period). Errors were identified, transcribed, coded, and entered into a database. The primary outcome was the frequency of prescribing errors during each period. A Bonferroni-adjusted chi-square analysis was conducted with an a priori experiment-wise alpha of 0.05.
A reduction in prescribing errors of 33% following the first intervention month and a mean 26% reduction during the study period were observed (P<0.0025). The frequencies of preintervention and postintervention errors did not differ significantly.
A straightforward educational intervention reduced prescribing errors during the period of active intervention, but this effect was not sustained. Ongoing communication and education about institution-specific medication errors appear warranted.
有几种复杂且成本高昂的干预措施可减少用药错误。关于向机构临床医生提供教育和反馈作为减少错误手段的有效性,相关研究较少。
确定由药剂师主导的教育干预对处方错误的影响。
前瞻性、中断时间序列研究。
本研究在拥有320张床位的托莱多大学医学中心的内科住院医师中进行。
教育干预于2006年11月开始,为期6个月。干预包括一场时长一小时的初始讲座,随后是每两周一次、然后每月一次的讨论,讨论使用特定机构及时出现的处方错误实例。
在5个时间点收集数据:第0个月(干预前期);第1、3和6个月(干预期);以及第7个月(干预后期)。识别错误、转录、编码并录入数据库。主要结果是每个时期的处方错误频率。进行了Bonferroni校正的卡方分析,先验实验性α值为0.05。
在第一个干预月后,处方错误减少了33%,在研究期间平均减少了26%(P<0.0025)。干预前和干预后的错误频率无显著差异。
一项直接的教育干预在积极干预期间减少了处方错误,但这种效果未持续。针对特定机构用药错误的持续沟通和教育似乎是必要的。