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临床药师干预对减少儿科处方错误的影响。

Impact of clinical pharmacist interventions in reducing paediatric prescribing errors.

机构信息

Pharmacy Service, Hospital General Universitario Gregorio Marañón, C/ Doctor Esquerdo 46, 28007 Madrid, Spain.

出版信息

Arch Dis Child. 2012 Jun;97(6):564-8. doi: 10.1136/archdischild-2011-301239. Epub 2012 Feb 22.

Abstract

OBJECTIVE

To assess the impact of pharmacist intervention in reducing prescribing errors in paediatrics, and to analyse the clinical significance and reasons behind the errors detected.

METHODS

Cross-sectional epidemiological study analysing the activities of the paediatric pharmacist in a maternity and children's hospital with 180 paediatric beds, between January 2007 and December 2009. The following variables were analysed: impact of the pharmacist's recommendation on patient care, reason for the intervention, clinical significance, type of negative outcome associated with the medication, acceptance rate, medication involved, intervention detection date and observations.

RESULTS

A total of 1475 interventions in medical orders for 14,713 paediatric patients were recorded (40 (2.9%) extremely significant interventions and 155 (11.1%) very significant interventions). There were 1357 prescribing errors, 833 of which were dosing errors. 2.2% of the errors detected were potentially fatal (30 cases) and 14.3% (194 cases) were clinically serious. The main reason for interventions was detection of a dosage between 1.5 and 10 times higher than that recommended. The overall rate of acceptance of the pharmacist's suggestions was 94.3%. The pharmacist carried out an average of 0.019 interventions per patient day throughout the study period.

CONCLUSION

Interventions by a clinical pharmacist had a major impact on reducing prescribing errors in the study period, thus improving the quality and safety of care provided.

摘要

目的

评估药剂师干预对减少儿科处方错误的影响,并分析检测到的错误的临床意义和原因。

方法

横断面流行病学研究分析了 2007 年 1 月至 2009 年 12 月期间在一家拥有 180 张儿科病床的妇产科和儿童医院的儿科药剂师的活动。分析了以下变量:药剂师建议对患者护理的影响、干预的原因、临床意义、与药物相关的负面结果的类型、接受率、涉及的药物、干预检测日期和观察结果。

结果

共记录了 1475 项对 14713 名儿科患者的医嘱干预(40 项(2.9%)为极显著干预,155 项(11.1%)为非常显著干预)。共发现 1357 项处方错误,其中 833 项为剂量错误。检测到的错误中有 2.2%(30 例)可能致命,14.3%(194 例)为临床严重。干预的主要原因是检测到的剂量比推荐剂量高 1.5 至 10 倍。药剂师建议的总体接受率为 94.3%。在整个研究期间,药剂师平均每天对每个患者进行 0.019 次干预。

结论

临床药剂师的干预对减少研究期间的处方错误产生了重大影响,从而提高了提供的护理质量和安全性。

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