Silvia Manrique-Rodríguez, Pharm.D., Ph.D., is Clinical Hospital Pharmacist; Amelia C. Sánchez-Galindo, M.D., is Intensive Care Pediatrician; and Jesús López-Herce, M.D., Ph.D., is Intensive Care Pediatrician, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Miguel Ángel Calleja-Hernández, Pharm.D., Ph.D., is Director, Pharmacy Service, Hospital Universitario Virgen de las Nieves, Granada, Spain. Fernando Martínez-Martínez, Pharm.D., Ph.D., is University Professor, Faculty of Pharmacy, Campus de Cartuja, Granada. Irene Iglesias-Peinado, Pharm.D., Ph.D., is University Professor, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid. Ángel Carrillo-Álvarez, M.D., Ph.D., is Director, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón. María Sanjurjo Sáez, Pharm.D., is Director; and Cecilia M. Fernández-Llamazares, Pharm.D., Ph.D., is Clinical Hospital Pharmacist, Pharmacy Service, Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón.
Am J Health Syst Pharm. 2013 Nov 1;70(21):1897-906. doi: 10.2146/ajhp120767.
The impact of smart infusion pumps on the interception of errors in the programming of i.v. drug administrations on a pediatric intensive care unit (PICU) is investigated.
A prospective observational intervention study was conducted in the PICU of a hospital in Madrid, Spain, to estimate the patient safety benefits resulting from the implementation of smart pump technology (Alaris System, CareFusion, San Diego, CA). A systematic analysis of data stored by the devices during the designated study period (January 2010-June 2011) was conducted using the system software (Guardrails CQI Event Reporter, CareFusion). The severity of intercepted errors was independently classified by a group of four clinical pharmacists and a group of four intensive care pediatricians; analyses of intragroup and intergroup agreement in perceptions of severity were performed.
During the 17-month study period, the overall rate of user compliance with the safety software was 78%. The use of smart pump technology resulted in the interception of 92 programming errors, 84% of which involved analgesics, antiinfectives, inotropes, and sedatives. About 97% of the errors resulted from user programming of doses or infusion rates above the hard limits defined in the smart pump drug library. The potential consequences of the intercepted errors were considered to be of moderate, serious, or catastrophic severity in 49% of cases.
The use of smart pumps in a PICU improved patient safety by enabling the interception of infusion programming errors that posed the potential for severe injury to pediatric patients.
研究智能输液泵对儿科重症监护病房（PICU）静脉药物给药编程错误的拦截效果。
在西班牙马德里一家医院的 PICU 中进行了一项前瞻性观察性干预研究，以评估智能输液泵技术（加利福尼亚州圣地亚哥的 CareFusion 公司的 Alaris 系统）实施所带来的患者安全效益。使用设备在指定研究期间（2010 年 1 月至 2011 年 6 月）存储的数据，使用系统软件（CareFusion 的 Guardrails CQI Event Reporter）进行了系统分析。由一组四名临床药师和一组四名儿科重症监护医师独立对拦截错误的严重程度进行分类；并对两组人员在严重程度认知方面的组内和组间一致性进行了分析。
在 17 个月的研究期间，用户遵守安全软件的总体比率为 78%。智能输液泵技术的使用导致 92 次编程错误被拦截，其中 84%涉及镇痛药、抗感染药、正性肌力药和镇静剂。约 97%的错误是由于用户在智能输液泵药物库中设定的剂量或输注率超过了硬限制而导致的。拦截错误的潜在后果在 49%的情况下被认为是中度、严重或灾难性的。
在 PICU 中使用智能输液泵可以通过拦截可能对儿科患者造成严重伤害的输液编程错误来提高患者安全性。
