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[一款用于改善出院时用药核对的软件应用程序的影响]

[Impact of a software application to improve medication reconciliation at hospital discharge].

作者信息

Corral Baena S, Garabito Sánchez M J, Ruíz Rómero M V, Vergara Díaz M A, Martín Chacón E R, Fernández Moyano A

机构信息

Servicio de Farmacia, Hospital San Juan de Dios del Aljarafe, Sevilla, España.

Servicio de Farmacia, Hospital San Juan de Dios del Aljarafe, Sevilla, España.

出版信息

Rev Calid Asist. 2014 Sep-Oct;29(5):278-86. doi: 10.1016/j.cali.2014.09.002. Epub 2014 Oct 6.

Abstract

BACKGROUND AND OBJECTIVE

To assess the impact of a software application to improve the quality of information concerning current patient medications and changes on the discharge report after hospitalization. To analyze the incidence of errors and to classify them.

MATERIAL AND METHOD DESIGN

Quasi-experimental pre / post study with non-equivalent control group study.

STUDY POPULATION

Medical patients at hospital discharge.

INTERVENTION

implementation of a software application.

VARIABLES

Percentage of reconciled patient medication on discharge, and percentage of patients with more than one unjustified discrepancy.

RESULTS

A total of 349 patients were assessed; 199 (pre-intervention phase) and 150 (post-intervention phase). Before the implementation of the application in 157 patients (78.8%) medication reconciliation had been completed; finding reconciliation errors in 99 (63.0%). The most frequent type of error, 339 (78.5%), was a missing dose or administration frequency information. After implementation, all the patient prescriptions were reconciled when the software was used. The percentage of patients with unjustified discrepancies decreased from 63.0% to 11.8% with the use of the application (p<.001). The main type of discrepancy found on using the application was confusing prescription, due to the fact that the professionals were not used to using the new tool.

CONCLUSIONS

The use of a software application has been shown to improve the quality of the information on patient treatment on the hospital discharge report, but it is still necessary to continue development as a strategy for improving medication reconciliation.

摘要

背景与目的

评估一款软件应用程序对改善当前患者用药信息质量以及住院后出院报告中用药变更信息质量的影响。分析错误发生率并进行分类。

材料与方法设计

采用非等效对照组的准实验性前后对照研究。

研究人群

出院时的内科患者。

干预措施

实施一款软件应用程序。

变量

出院时患者用药核对的百分比,以及存在不止一处不合理差异的患者百分比。

结果

共评估了349例患者;199例(干预前阶段)和150例(干预后阶段)。在应用程序实施前,157例患者(78.8%)完成了用药核对;其中99例(63.0%)发现了核对错误。最常见的错误类型为339例(78.5%),是漏记剂量或给药频次信息。实施后,使用该软件时所有患者的处方均完成了核对。使用该应用程序后,存在不合理差异的患者百分比从63.0%降至11.8%(p<0.001)。使用该应用程序时发现的主要差异类型是处方混淆,原因是专业人员不习惯使用新工具。

结论

已证明使用软件应用程序可提高出院报告中患者治疗信息的质量,但作为改善用药核对的一项策略仍有必要继续改进。

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