South Carolina College of Pharmacy-USC, Columbia, USA.
Ann Pharmacother. 2010 Nov;44(11):1739-46. doi: 10.1345/aph.1P252. Epub 2010 Oct 19.
Nighttime and weekend admission has been associated with increased morbidity and mortality and has been linked to a variety of factors. Medication errors in hospitalized patients occur frequently, but the association between error rates and time of day and day of week (weekday vs weekend) has not been extensively studied.
To compare reported medication error rates over a 1-year period between daytime versus nighttime shifts and weekday versus weekend in a children's hospital and to characterize the types of errors that occurred.
One hundred forty errors reported between January and December 2008 were retrospectively reviewed and classified by error type and severity according to established standards. Two investigators independently classified errors, and a third investigator with pediatric pharmacy expertise resolved discrepancies. Data on doses dispensed were collected from pharmacy records.
Over the study period, the reported error rate during daytime nursing shifts was 1.17 errors per 1000 doses dispensed versus 2.12 errors per 1000 doses dispensed for nighttime nursing shifts (p = 0.005). The error rates during pharmacy shifts (1st, 2nd, and 3rd) were 1.01, 2.24, and 1.88 per 1000 doses dispensed, respectively (p = 0.0019). Reported errors for weekday versus weekend were 1.9 errors per 1000 weekday doses versus 2.55 errors per 1000 doses, respectively (p = 0.181), and error rate for weekend shifts relative to first shift on weekdays was greater (p = 0.0004). Errors in medication administration, followed by dispensing errors, occurred most frequently.
There was an increase in medication error rate during evening and nighttime shifts relative to day shift and during weekends relative to weekdays at this institution. Additional studies to validate this finding are needed; however, error prevention efforts should be instituted now for evening, nighttime, and weekend medication dispensing and administration.
夜间和周末入院与发病率和死亡率的增加有关，并且与多种因素有关。住院患者经常发生用药错误，但错误率与一天中的时间和一周中的天数（工作日与周末）之间的关联尚未得到广泛研究。
比较一家儿童医院一年内白天与夜间班次以及工作日与周末班次之间报告的用药错误率，并描述发生的错误类型。
回顾性审查了 2008 年 1 月至 12 月期间报告的 140 个错误，并根据既定标准按错误类型和严重程度进行分类。两名调查员独立分类错误，具有儿科药学专业知识的第三名调查员解决差异。从药房记录中收集了剂量分配数据。
在研究期间，白天护理班次报告的错误率为每 1000 剂 1.17 个错误，而夜间护理班次为每 1000 剂 2.12 个错误（p = 0.005）。药房班次（第 1、2 和 3 班次）的错误率分别为每 1000 剂 1.01、2.24 和 1.88（p = 0.0019）。与周末相比，工作日报告的错误为每 1000 剂工作日 1.9 个错误，每 1000 剂周末 2.55 个错误（p = 0.181），并且周末班次相对于平日第一班次的错误率更高（p = 0.0004）。给药错误和配药错误最为常见。
在该机构，夜间和夜间班次相对于日间班次以及周末相对于工作日的用药错误率增加。需要进行更多研究来验证这一发现；但是，现在应该为夜间、夜间和周末的药物配药和给药实施错误预防措施。
