Medical Education Centre, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
Int J Qual Health Care. 2013 Oct;25(5):564-72. doi: 10.1093/intqhc/mzt044. Epub 2013 Jun 5.
To investigate the changes in overdue doses rates over a 4-year period in an National Health Service (NHS) teaching hospital, following the implementation of interventions associated with an electronic prescribing system used within the hospital.
Retrospective time-series analysis of weekly dose administration data.
University teaching hospital using a locally developed electronic prescribing and administration system (Prescribing, Information and Communication System or PICS) with an audit database containing details on every drug prescription and dose administration.
Prescription data extracted from the PICS database.
INTERVENTION(S): Four interventions were implemented in the Trust: (i) the ability for doctors to pause medication doses; (ii) clinical dashboards; (iii) visual indicators for overdue doses and (iv) overdue doses Root Cause
(RCA) meetings and a National Patient Safety Agency (NPSA) Rapid Response Alert. Main outcome measure(s) The percentage of missed medication doses.
Rates of both missed antibiotic and non-antibiotic doses decreased significantly upon the introduction of clinical dashboards (reductions of 0.60 and 0.41 percentage points, respectively), as well as following the instigation of executive-led overdue doses RCA meetings (reductions of 0.83 and 0.97 percentage points, respectively) and the publication of an associated NPSA Rapid Response Alert. Implementing a visual indicator for overdue doses was not associated with significant decreases in the rates of missed antibiotic or non-antibiotic doses.
Electronic prescribing systems can facilitate data collection relating to missed medication doses.
providing hospital staff with information about overdue doses at a ward level can help promote reductions in overdue doses rates.
在一家国民保健制度（NHS）教学医院实施与医院内使用的电子处方系统相关的干预措施后，调查 4 年内逾期剂量率的变化。
每周剂量给药数据的回顾性时间序列分析。
使用本地开发的电子处方和管理系统（处方、信息和通信系统或 PICS）的大学教学医院，该系统具有包含每个药物处方和剂量管理详细信息的审计数据库。
从 PICS 数据库中提取处方数据。
在信托基金中实施了四项干预措施：（i）医生暂停药物剂量的能力；（ii）临床仪表板；（iii）逾期剂量的视觉指标和（iv）逾期剂量根本原因分析（RCA）会议和国家患者安全局（NPSA）快速反应警报。
错过药物剂量的百分比。
引入临床仪表板后，抗生素和非抗生素剂量的漏服率显著降低（分别降低 0.60 和 0.41 个百分点），以及实施由行政领导主导的逾期剂量 RCA 会议（分别降低 0.83 和 0.97 个百分点）和发布相关的 NPSA 快速反应警报后。实施逾期剂量的视觉指标与抗生素或非抗生素剂量漏服率的显著降低无关。
电子处方系统可以方便地收集与漏服药物剂量相关的数据。
向医院工作人员提供关于病房逾期剂量的信息，可以帮助降低逾期剂量率。
