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静脉推注方法错误率的比较:一项前瞻性、多中心、观察性研究。

A Comparison of Error Rates Between Intravenous Push Methods: A Prospective, Multisite, Observational Study.

作者信息

Hertig John B, Degnan Daniel D, Scott Catherine R, Lenz Janelle R, Li Xiaochun, Anderson Chelsea M

出版信息

J Patient Saf. 2018 Mar;14(1):60-65. doi: 10.1097/PTS.0000000000000419.

Abstract

OBJECTIVES

Current literature estimates the error rate associated with the preparation and administration of all intravenous (IV) medications to be 9.4% to 97.7% worldwide. This study aims to compare the number of observed medication preparation and administration errors between the only commercially available ready-to-administer product (Simplist) and IV push traditional practice, including a cartridge-based syringe system (Carpuject) and vials and syringes.

METHODS

A prospective, multisite, observational study was conducted in 3 health systems in various states within the United States between December 2015 and March 2016 to observe IV push medication preparation and administration. Researchers observed a ready-to-administer product and IV push traditional practice using a validated observational method and a modified data collection sheet. All observations were reconciled to the original medication order to determine if any errors occurred.

RESULTS

Researchers collected 329 observations (ready to administer = 102; traditional practice = 227) and observed 260 errors (ready to administer = 25; traditional practice = 235). The overall observed error rate for ready-to-administer products was 2.5%, and the observed error rate for IV push traditional practice was 10.4%.

CONCLUSIONS

The ready-to-administer group demonstrated a statistically significant lower observed error rate, suggesting that use of this product is associated with fewer observed preparation and administration errors in the clinical setting. Future studies should be completed to determine the potential for patient harm associated with these errors and improve clinical practice because it relates to the safe administration of IV push medications.

摘要

目的

当前文献估计,在全球范围内,所有静脉注射(IV)药物的配制和给药相关错误率为9.4%至97.7%。本研究旨在比较唯一市售的即配即用产品(Simplist)与静脉推注传统操作(包括基于药筒的注射器系统(卡普捷注射器)以及小瓶和注射器)之间观察到的药物配制和给药错误数量。

方法

2015年12月至2016年3月期间,在美国不同州的3个医疗系统中进行了一项前瞻性、多中心观察性研究,以观察静脉推注药物的配制和给药情况。研究人员使用经过验证的观察方法和修改后的数据收集表,观察了即配即用产品和静脉推注传统操作。所有观察结果均与原始医嘱核对,以确定是否发生任何错误。

结果

研究人员收集了329次观察结果(即配即用 = 102次;传统操作 = 227次),并观察到260次错误(即配即用 = 25次;传统操作 = 235次)。即配即用产品的总体观察错误率为2.5%,静脉推注传统操作的观察错误率为10.4%。

结论

即配即用组的观察错误率在统计学上显著较低,这表明在临床环境中使用该产品与观察到的配制和给药错误较少相关。未来应完成研究,以确定与这些错误相关的患者伤害可能性,并改善临床实践,因为这与静脉推注药物的安全给药有关。

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