Gilmartin Julia Fiona-Maree, Marriott Jennifer Lillian, Hussainy Safeera Yasmeen
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia.
Australas J Ageing. 2016 Jun;35(2):E1-6. doi: 10.1111/ajag.12236. Epub 2015 Oct 21.
The study aims to determine the impact of a quality improvement intervention on how accurately and suitably medicines are supplied to residents of residential aged-care facilities (RACFs).
Between September 2012 and January 2013, pharmacy-supplied dose administration aids (DAAs) were audited at 45 Victorian RACFs (Australia). RACFs had previously received an intervention (education session/toolkit) and were involved in an earlier DAA audit. Recently supplied DAAs containing regular medicines were compared to prescriber-prepared medicine charts to identify, and classify risks of, inaccurate or unsuitable packing incidents.
Of 2389 DAAs audited for 983 residents, 770 incidents in 502 DAAs were identified. The overall DAA incident rate increased significantly from 11.5% pre-intervention to 21.0% post-intervention (P < 0.001). The proportion of DAAs affected by incidents classified as 'insignificant' or 'minor' risk increased post-intervention (P < 0.001).
Further wide-scale evaluation of RACF medicine supply services is needed. Interventions that are effective in reducing DAA incidents should be explored.
本研究旨在确定质量改进干预措施对向老年护理机构（RACFs）居民供应药品的准确性和适宜性的影响。
2012年9月至2013年1月期间，对澳大利亚维多利亚州的45家老年护理机构中由药房提供的剂量给药辅助工具（DAAs）进行了审核。这些老年护理机构此前接受过一次干预措施（培训课程/工具包），并参与了早期的剂量给药辅助工具审核。将近期提供的包含常规药物的剂量给药辅助工具与处方医生准备的药物图表进行比较，以识别和分类不准确或不适宜包装事件的风险。
在对983名居民的2389份剂量给药辅助工具进行审核时，在502份剂量给药辅助工具中发现了770起事件。剂量给药辅助工具的总体事件发生率从干预前的11.5%显著增加到干预后的21.0%（P < 0.001）。干预后，被归类为“不严重”或“轻微”风险事件影响的剂量给药辅助工具比例有所增加（P < 0.001）。
需要对老年护理机构的药品供应服务进行进一步的大规模评估。应探索有效减少剂量给药辅助工具事件的干预措施。
