Abbasinazari Mohammad, Hajhossein Talasaz Azita, Eshraghi Azadeh, Sahraei Zahra
Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Aug 7;51(7):482-6.
Any suboptimum treatment in the management of patients can lead to medication errors (MEs) that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each). Wrong frequency 71 (27%), forget to order 37 (14.1%), wrong selection 33 (12.5%), drug interactions 26 (9.9%), forget to discontinue 25 (9.5%) and inappropriate dose adjustment in renal impairment 25 (9.5%) were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6%) followed by gastrointestinal agents (15.6%). Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists.
患者管理中的任何次优治疗都可能导致用药错误(MEs),这可能会增加住院患者的发病率和死亡率。通过在管理式医疗环境中建立精心设计的患者护理活动,临床药师可以与其他医疗保健专业人员合作,提供优质护理并最大限度地提高安全性。本研究的目的是评估临床药师用药错误的发生率及预防情况。这是一项在一家教学医院内科病房进行的为期两个月的横断面干预性研究。在此期间,临床药师对患者记录和医生医嘱进行了审查。发现的任何处方错误都进行了记录。药物选择、剂量、剂型、用药频率或给药途径错误均被视为用药错误。然后,临床药师与临床研究员讨论研究结果,以更改错误医嘱。记录了临床药师在不同病房检测到并预防的用药错误的发生率和类型。在研究期间,在132名患者中检测到262处错误(每人1.98处)。错误的用药频率71处(27%)、忘记开医嘱37处(14.1%)、错误选择33处(12.5%)、药物相互作用26处(9.9%)、忘记停药25处(9.5%)以及肾功能损害时剂量调整不当25处(9.5%)是最常见的错误类型。心血管药物是检测到错误最多的类别(31.6%),其次是胃肠道药物(15.6%)。用药错误是内科病房常见的问题,通过临床药师的干预,其发生率可以得到限制。