Baqir Wasim, Jones Kate, Horsley William, Barrett Scott, Fisher David, Copeland Richard, Campbell David, Stephenson Rosemary
Northumbria Healthcare NHS Foundation Trust, Pharmacy, North Tyneside Hospital, North Shields, UK.
Evaluation Research and Development Unit, School of Medicine, Health Wolfson Research Institute, Durham University, Stockton-on-Tees, UK.
Int J Pharm Pract. 2015 Oct;23(5):327-32. doi: 10.1111/ijpp.12172. Epub 2015 Jan 28.
The potential harm from omitted and delayed medicines for hospital inpatients was highlighted by the National Patient Safety Agency (NPSA). Despite evidence of omitted doses, few interventional studies have been reported on preventing the problem. This study aimed to assess the impact on omitted doses when medicine administration was supported by pharmacy assistants (PAs).
PAs were trained to support nurses on medicine administration rounds. Using stratified random sampling, two intervention and control wards were selected. Three study groups were defined: (A) intervention group (PA-supported medicine administration); (B) intra-ward control group; and (C) inter-ward control group. Primary outcome measure was number of patients with unacceptable omitted doses (UODs) in group A versus C. Secondary outcome measures were patients with critical UOD (cUOD), as defined by the NPSA, in groups A, B and C and UODs in group B versus A and C. Data were collected over 2 weeks (December 2011 and February 2012).
Using aggregated data over 2 weeks, 778 patients were assessed; 308 were male (40%). The overall proportion of patients with ≥1 UOD was 12.4% (n = 96). The proportion of patients with ≥1 UOD was 1.1% (n = 2) in group A (intervention) and 18.5% (n = 68) in group C (control). There were significantly fewer patients with cUOD in group A (1.1%; n = 2) compared with group C (7.4%; n = 27).
PA-supported medication rounds can significantly reduce the rate of omitted doses. This study provides evidence for a potential solution to the problem of omitted doses for hospital inpatients.
国家患者安全机构（NPSA）强调了住院患者药物漏服和延迟服用可能造成的危害。尽管有药物漏服剂量的相关证据，但关于预防该问题的干预性研究报道较少。本研究旨在评估药房助理（PA）协助给药时对药物漏服剂量的影响。
对药房助理进行培训，使其在给药查房时协助护士。采用分层随机抽样法，选取两个干预组病房和对照组病房。定义了三个研究组：（A）干预组（由药房助理协助给药）；（B）病房内对照组；（C）病房间对照组。主要观察指标是A组与C组中出现不可接受漏服剂量（UOD）的患者数量。次要观察指标是A、B、C组中出现国家患者安全机构定义的严重不可接受漏服剂量（cUOD）的患者数量，以及B组与A组和C组相比的漏服剂量情况。数据收集时间为2周（2011年12月和2012年2月）。
使用2周的汇总数据，共评估了778例患者；其中308例为男性（40%）。出现≥1次漏服剂量的患者总体比例为12.4%（n = 96）。A组（干预组）中出现≥1次漏服剂量的患者比例为1.1%（n = 2），C组（对照组）为18.5%（n = 68）。与C组（7.4%；n = 27）相比，A组中出现严重不可接受漏服剂量的患者明显更少（1.1%；n = 2）。
药房助理协助给药查房可显著降低漏服剂量率。本研究为解决住院患者药物漏服问题提供了一种潜在的解决方案。
