University of Utah School of Medicine, Salt Lake City, Utah 84132-2101, USA.
Telemed J E Health. 2012 Sep;18(7):530-7. doi: 10.1089/tmj.2011.0222. Epub 2012 Jul 23.
Medication errors contribute to a significant number of fatal and nonfatal adverse medical events each year. Many actions, from both a policy and innovation standpoint, have been taken to reduce medication errors in the inpatient setting; yet, these actions often target larger urban hospitals. Rural hospitals face many more challenges in implementing these changes due to fewer resources and lower patient volumes. Our article discusses the implementation and results of a telepharmacy demonstration implemented between the University of California Davis Health System and six rural hospitals.
A retrospective chart review obtained baseline medication errors for comparison with the prospective review of medication orders through telepharmacy. Medication orders from rural hospitals were transmitted via fax to the University of California Davis Pharmacy for after-hours review. If a medication required after-hours removal from the pharmacy, it was requested that video verification by a telepharmacist be used to verify that the correct medication was removed from the pharmacy.
Baseline findings from the retrospective chart review indicated that 30.0% of patients had one or more medication errors and that these errors occurred in 7.2% of the medication orders. None of these errors were found to have resulted in harm to the patients. During the telepharmacy demonstration, 2,378 medication orders were screened from 504 independent order review requests. In total, 58 (19.2%) patients had one or more medication errors. The errors from the telepharmacy demonstration represented potential errors that were identified through telepharmacy medication review.
Telepharmacy represents a potential alternative to around-the-clock on-site pharmacist medication review for rural hospitals.
每年，用药错误都会导致大量的致命和非致命的医疗不良事件。从政策和创新的角度来看，已经采取了许多行动来减少住院患者的用药错误；然而，这些行动通常针对更大的城市医院。由于资源较少和患者数量较少，农村医院在实施这些变革方面面临着更多的挑战。我们的文章讨论了加利福尼亚大学戴维斯卫生系统与六家农村医院之间实施的远程药学示范项目的实施情况和结果。
回顾性病历审查获得了用药错误的基线数据，以便与通过远程药学进行的前瞻性用药医嘱审查进行比较。农村医院的用药医嘱通过传真发送到加利福尼亚大学戴维斯药房进行夜间审查。如果需要夜间从药房取出药物，则要求通过远程药师进行视频验证，以验证从药房取出了正确的药物。
回顾性病历审查的基线发现表明，30.0%的患者有一个或多个用药错误，这些错误发生在 7.2%的用药医嘱中。这些错误都没有导致患者受到伤害。在远程药学示范期间，从 504 个独立的医嘱审查请求中筛选了 2378 个用药医嘱。总共有 58 名（19.2%）患者有一个或多个用药错误。远程药学示范中的错误代表了通过远程药学用药审查发现的潜在错误。
远程药学为农村医院提供了一种替代 24 小时现场药师用药审查的潜在方法。
