Lloyd Michael, Watmough Simon David, O'Brien Sarah Victoria, Hardy Kevin, Furlong Niall
Pharmacy Department, St. Helens and Knowsley Teaching Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK.
Postgraduate Professional Development, Faculty of Health and Social Care, Edge Hill University, Ormskirk, L39 4QP, UK.
Int J Clin Pharm. 2017 Oct;39(5):1013-1017. doi: 10.1007/s11096-017-0503-x. Epub 2017 Jul 11.
Background Prescribing errors are prevalent in hospital settings with feedback identified as one potential error reduction strategy. Hospital pharmacists work alongside prescribers at ward level and are credible facilitators of prescribing error feedback. A formalised programme of pharmacist-led prescribing error feedback was designed and implemented Objective To determine the impact of the feedback intervention on prescribing error rates. Method Prospective prescribing audits were undertaken at baseline for control (n = 11) and intervention group (n = 10) prescribers. The intervention group received pharmacist-led, individualised constructive feedback on their prescribing, whilst the control group continued with existing practice. Prescribing was re-audited following 3-months of the intervention. Data were analysed using chi-squared and independent t-tests. Results Error frequency (123/641 intervention and 121/649 control) was comparable between groups at baseline (p = 0.819) with significant differences (90/1677 intervention and 236/984 control) post intervention (p = <0.005). Prescribing error rates were lower in the intervention group (mean change of -11.5%) and higher in the control group (mean change of +5.9%) following the intervention, with a mean significant difference of 17.4% (SD 4.7, 95% CI, -27.3 to -7.6), t = -3.694, p < 0.05, between groups. Conclusion Pharmacist-led prescribing error feedback positively influences prescribing. This intervention shows promise for wider application in hospital settings to optimise patient safety.
处方错误在医院环境中很普遍，反馈被认为是一种潜在的减少错误策略。医院药剂师在病房层面与开处方者合作，是处方错误反馈的可靠促进者。设计并实施了一项由药剂师主导的处方错误反馈正式计划。目的：确定反馈干预对处方错误率的影响。方法：对对照组（n = 11）和干预组（n = 10）的开处方者进行基线前瞻性处方审核。干预组接受药剂师主导的、针对其处方的个性化建设性反馈，而对照组继续现有做法。干预3个月后重新审核处方。使用卡方检验和独立t检验分析数据。结果：基线时两组的错误频率（干预组123/641，对照组121/649）相当（p = 0.819），干预后有显著差异（干预组90/1677，对照组236/984）（p = <0.005）。干预后，干预组的处方错误率较低（平均变化-11.5%），对照组较高（平均变化+5.9%），两组间平均显著差异为17.4%（标准差4.7，95%可信区间，-27.3至-7.6），t = -3.694，p < 0.05。结论：药剂师主导的处方错误反馈对处方有积极影响。这种干预显示出在医院环境中更广泛应用以优化患者安全的前景。
