澳大利亚养老院中的药品：一项关于重新包装药品以装入药房供应的剂量给药辅助器具的准确性和适用性的横断面观察性研究。
Medicines in Australian nursing homes: a cross-sectional observational study of the accuracy and suitability of re-packing medicines into pharmacy-supplied dose administration aids.
机构信息
Centre for Medicine Use and Safety, Monash University Melbourne, Australia.
出版信息
Res Social Adm Pharm. 2013 Nov-Dec;9(6):876-83. doi: 10.1016/j.sapharm.2013.01.002. Epub 2013 Mar 15.
BACKGROUND
Though staff at Australian nursing homes (NHs) commonly administer medicines that have been re-packed into dose administration aids (DAAs) that organize medicines according to dose schedule, these pharmacy-supplied devices have not been extensively evaluated in the Australian setting.
OBJECTIVE
To audit the accuracy and suitability of re-packing medicines into DAAs (blister packs or sachets) for NHs and identify the proportion of DAAs with inaccurate or unsuitable medicine re-packing.
METHODS
Between January and June 2011, pharmacist researchers visited 49 randomly and purposively selected NHs from rural, regional, and metropolitan Victoria (Australia) to audit a sample of residents' newly prepared DAAs that contained all of their regularly re-packed medicines for 1 week. Over 1 or 2 days, the pharmacy-supplied DAAs were compared with the current prescriber-prepared NH medicine chart. Any occurrences of inaccurately re-packed medicines (discrepancies, with verification as necessary) or unsuitable medicine re-packing were recorded as DAA incidents and descriptive statistics was used to analyze the data.
RESULTS
Six hundred and eighty-four incidents occurring in 457 DAAs were detected from a total of 3959 DAAs audited for 1757 residents (incident rate of 11.5% of DAAs) from 49 participating NHs. Incidents were detected in 10.5% of blister packs and 14.5% of sachets. The top five incidents were unsuitable re-packing according to pharmaceutical guidelines (50.1%); added medicine (9.8%); incorrect quantity re-packed (5.4%); omitted medicine (5.3%); and damaged medicine (5.1%).
CONCLUSIONS
The incident rate of inaccurate or unsuitable medicine re-packing within DAAs supplied to NHs for use in medicine administration was higher than in previous research. Recommendations include using current findings in conjunction with further research to develop a quality improvement initiative to reduce DAA incident rates and improve NH standard of care.
背景
尽管澳大利亚养老院（NH）的工作人员通常会管理根据剂量时间表组织药物的剂量给药辅助器具（DAA）中重新包装的药物，但这些药房供应的设备尚未在澳大利亚进行广泛评估。
目的
审核将药物重新包装到 DAA（泡罩包装或小袋）中以供 NH 使用的准确性和适宜性，并确定 DAA 中药物重新包装不准确或不适宜的比例。
方法
在 2011 年 1 月至 6 月期间，药剂师研究人员访问了澳大利亚维多利亚州农村、地区和城市的 49 家随机和有目的选择的 NH，以审核居民新准备的 DAA 中包含他们所有定期重新包装的药物的样本，为期一周。在 1 天或 2 天内，药房供应的 DAA 与当前的处方准备的 NH 药物图表进行了比较。记录了任何不准确的重新包装药物（如有必要进行核实）或不适宜的药物重新包装的情况，将其记录为 DAA 事件，并使用描述性统计数据对数据进行分析。
结果
从总共审核的 3959 个 DAA 中，发现了 457 个 DAA 中的 684 个事件，这些 DAA 涉及 49 家参与的 NH 中的 1757 名居民（DAA 发生率为 11.5%）。在泡罩包装中发现了 10.5%的事件，在小袋中发现了 14.5%的事件。排名前五的事件是根据药物指南进行的不适宜的重新包装（50.1%）；添加药物（9.8%）；重新包装的数量不正确（5.4%）；遗漏药物（5.3%）；和损坏的药物（5.1%）。
结论
在 NH 用于给药的 DAA 中，药物重新包装不准确或不适宜的事件发生率高于先前的研究。建议包括将当前研究结果与进一步研究结合起来，制定一项质量改进计划，以降低 DAA 事件发生率并提高 NH 的护理标准。
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