Vilà-de-Muga Mònica, Colom-Ferrer Laura, Gonzàlez-Herrero Mariona, Luaces-Cubells Carles
Pediatric Emergency Department, Hospital Universitari Sant Joan de Déu, Barcelona, Spain.
Pediatr Emerg Care. 2011 Apr;27(4):290-4. doi: 10.1097/PEC.0b013e31821313c2.
To describe the prevalence, type, and factors associated with medication errors in a pediatric emergency department.
This is a descriptive retrospective study about the treatments administered in the pediatric emergency department during a week in November 2007. We used the protocols and clinical guides at our center as pattern of reference. The errors were classified as follows: (1) prescription error: drug involved, indication, dose, and route of administration; (2) severity of the error; and (3) associated factors: triage category, age of the patient, training level of the physician, day of the week, and hour of the day.
In 377 of 1906 checked reports, some treatments were prescribed. A total of 92 errors (15%) were detected and all of them were prescription errors: 50 (8%) for inappropriate indication and 42 (7 %) for inadequate dose. Also, 87 were considered insignificant errors, 5 were moderate and none were severe. There was a higher rate of errors among residents with less experience. We did not find differences in the triage category neither in the age of the patient. In the weekends and holidays, we commit more errors compared in weekdays (28% vs 18 %, P=0.02). Between 24 and 8 hours, we registered more errors than between 8 and 16 and between 16 and 24 hours (32.3% vs 17.9% vs 21.2%; P=0.03).
Error rates in drugs administered exclusively in the emergency department are slightly higher than others evaluating house orders and emergency department treatments. The high assistance pressure during weekends and holidays and the tiredness during the night are risk factors of prescribing errors. Periodical evaluation of the prescriptions is necessary to develop the best strategies to apply every time.
描述儿科急诊科用药错误的发生率、类型及相关因素。
这是一项描述性回顾性研究，针对2007年11月某一周儿科急诊科的治疗情况。我们以本中心的诊疗规范和临床指南作为参考标准。错误分类如下：（1）处方错误：涉及的药物、适应证、剂量及给药途径；（2）错误的严重程度；（3）相关因素：分诊类别、患者年龄、医生培训水平、星期几及一天中的时间。
在1906份检查报告中的377份里，开出了一些治疗处方。共检测到92处错误（15%），均为处方错误：50处（8%）为适应证不当，42处（7%）为剂量不足。此外，87处被认为是轻微错误，5处为中度错误，无严重错误。经验较少的住院医师出错率更高。我们未发现分诊类别和患者年龄方面存在差异。在周末和节假日，我们犯的错误比工作日更多（28%对18%，P = 0.02）。在24点至8点之间，我们记录到的错误比8点至16点以及16点至24点之间更多（32.3%对17.9%对21.2%；P = 0.03）。
仅在急诊科给药的错误率略高于其他评估住院医嘱和急诊科治疗的研究。周末和节假日期间的高就诊压力以及夜间的疲劳是处方错误的风险因素。定期评估处方对于制定每次应用的最佳策略很有必要。
