Cherif A, Sayadi M, Ben Hmida H, Ben Ameur K, Mestiri K
Service pharmacie, centre de maternité et de néonatologie, Monastir, Tunisie; Faculté de pharmacie, Monastir, Tunisie.
Service pharmacie, centre de maternité et de néonatologie, Monastir, Tunisie; Faculté de pharmacie, Monastir, Tunisie.
Ann Pharm Fr. 2015 Nov;73(6):461-70. doi: 10.1016/j.pharma.2015.04.001. Epub 2015 May 16.
Use of injectable drugs in newborns represents more than 90% of prescriptions and requires special precautions in order to ensure more safety and efficiency. The aim of this study is to gather errors relating to the administration of injectable drugs and to suggest corrective actions.
This descriptive and transversal study has evaluated 300 injectable drug administrations in a neonatology unit. Two hundred and sixty-one administrations have contained an error. Data are collected by direct observations of administrative act.
Errors observed are: an inappropriate mixture (2.6% of cases); an incorrect delivery rate (33.7% of cases); incorrect dilutions (26.7% of cases); error in calculation of the dose to be injected (16.7% of cases); error while sampling small volumes (6.3% of cases); error or omission of administration schedule (1% of cases).
These data have enabled us to evaluate administration of injectable drugs in neonatology. Different types of errors observed could be a source of therapeutic inefficiency, extended lengths of stay or iatrogenic drug. Following these observations, corrective actions have been undertaken by pharmacists and consist of: organizing training sessions for nursing; developing an explanatory guide for dilution and administration of injectable medicines, which was made available to the clinical service. Collaborative strategies doctor-nurse-pharmacist can help to reduce errors in the medication process especially during his administration. It permits improvement of injectable drugs use, offering more security and better efficiency and contribute to guarantee ideal therapy for patients.
新生儿注射用药占处方的90%以上，为确保更高的安全性和有效性，需要采取特殊预防措施。本研究的目的是收集与注射用药给药相关的差错，并提出纠正措施。
这项描述性横断面研究评估了新生儿科300次注射用药给药情况。其中261次给药存在差错。数据通过对管理行为的直接观察收集。
观察到的差错有：混合不当（2.6%的病例）；给药速率错误（33.7%的病例）；稀释错误（26.7%的病例）；注射剂量计算错误（16.7%的病例）；抽取小剂量时出错（6.3%的病例）；给药时间表错误或遗漏（1%的病例）。
这些数据使我们能够评估新生儿科注射用药的给药情况。观察到的不同类型差错可能是治疗无效、住院时间延长或医源性药物问题的根源。基于这些观察结果，药剂师已采取纠正措施，包括：为护理人员组织培训课程；编写注射用药稀释和给药说明指南，并提供给临床科室。医生 - 护士 - 药剂师的协作策略有助于减少用药过程中的差错，尤其是给药期间的差错。这有助于改善注射用药的使用，提高安全性和效率，并有助于为患者保证理想的治疗。
