Venkataraman Aishwarya, Siu Emily, Sadasivam Kalaimaran
Royal London Hospital, Barts Health NHS Trust, UK.
Pharmacy Department, Royal London Hospital, Barts Health NHS Trust, UK.
J Intensive Care Soc. 2016 Nov;17(4):290-294. doi: 10.1177/1751143716644456. Epub 2016 May 6.
Medication errors, including infusion prescription errors are a major public health concern, especially in paediatric patients. There is some evidence that electronic or web-based calculators could minimise these errors.
To evaluate the impact of an electronic infusion calculator on the frequency of infusion errors in the Paediatric Critical Care Unit of The Royal London Hospital, London, United Kingdom.
We devised an electronic infusion calculator that calculates the appropriate concentration, rate and dose for the selected medication based on the recorded weight and age of the child and then prints into a valid prescription chart. Electronic infusion calculator was implemented from April 2015 in Paediatric Critical Care Unit. A prospective study, five months before and five months after implementation of electronic infusion calculator, was conducted. Data on the following variables were collected onto a proforma: medication dose, infusion rate, volume, concentration, diluent, legibility, and missing or incorrect patient details.
A total of 132 handwritten prescriptions were reviewed prior to electronic infusion calculator implementation and 119 electronic infusion calculator prescriptions were reviewed after electronic infusion calculator implementation. Handwritten prescriptions had higher error rate (32.6%) as compared to electronic infusion calculator prescriptions (<1%) with a < 0.001. Electronic infusion calculator prescriptions had no errors on dose, volume and rate calculation as compared to handwritten prescriptions, hence warranting very few pharmacy interventions.
Use of electronic infusion calculator for infusion prescription significantly reduced the total number of infusion prescribing errors in Paediatric Critical Care Unit and has enabled more efficient use of medical and pharmacy time resources.
用药错误，包括输液处方错误，是一个重大的公共卫生问题，尤其是在儿科患者中。有证据表明，电子或基于网络的计算器可以减少这些错误。
评估电子输液计算器对英国伦敦皇家伦敦医院儿科重症监护病房输液错误发生率的影响。
我们设计了一种电子输液计算器，它根据记录的儿童体重和年龄，计算所选药物的适当浓度、速率和剂量，然后打印到有效的处方图表中。电子输液计算器于2015年4月在儿科重症监护病房投入使用。在电子输液计算器实施前五个月和实施后五个月进行了一项前瞻性研究。以下变量的数据被记录在一份表格上：药物剂量、输液速率、体积、浓度、稀释剂、易读性以及患者详细信息缺失或错误。
在电子输液计算器实施前，共审查了132份手写处方，在实施后，审查了119份电子输液计算器处方。手写处方的错误率（32.6%）高于电子输液计算器处方（<1%），P<0.001。与手写处方相比，电子输液计算器处方在剂量、体积和速率计算方面没有错误，因此几乎不需要药房干预。
使用电子输液计算器进行输液处方显著减少了儿科重症监护病房输液处方错误的总数，并使医疗和药房时间资源得到更有效的利用。
