Hasni Nesrine, Ben Hamida Emira, Ben Jeddou Khouloud, Ben Hamida Sarra, Ayadi Imene, Ouahchi Zeineb, Marrakchi Zahra
Tunis Med. 2016 Dec;94(12):884.
The medication iatrogenic risk is quite unevaluated in neonatology Objective: Assessment of errors that occurred during the preparation and administration of injectable medicines in a neonatal unit in order to implement corrective actions to reduce the occurrence of these errors.
A prospective, observational study was performed in a neonatal unit over a period of one month. The practice of preparing and administering injectable medications were identified through a standardized data collection form. These practices were compared with summaries of the characteristics of each product (RCP) and the bibliography.
One hundred preparations were observed of 13 different drugs. 85 errors during preparations and administration steps were detected. These errors were divided into preparation errors in 59% of cases such as changing the dilution protocol (32%), the use of bad solvent (11%) and administration errors in 41% of cases as errors timing of administration (18%) or omission of administration (9%).
This study showed a high rate of errors during stages of preparation and administration of injectable drugs. In order to optimize the care of newborns and reduce the risk of medication errors, corrective actions have been implemented through the establishment of a quality assurance system which consisted of the development of injectable drugs preparation procedures, the introduction of a labeling system and staff training.
新生儿科药物医源性风险评估尚不充分。目的：评估新生儿病房注射用药物配制和给药过程中出现的差错，以便采取纠正措施减少此类差错的发生。
在一家新生儿病房进行了为期1个月的前瞻性观察研究。通过标准化数据收集表确定注射用药物的配制和给药操作。将这些操作与每种产品的特性摘要（RCP）及参考文献进行比较。
观察了13种不同药物的100次配制。在配制和给药步骤中检测到85处差错。这些差错中，59%为配制差错，如改变稀释方案（32%）、使用不当溶剂（11%）；41%为给药差错，如给药时间错误（18%）或漏给药（9%）。
本研究显示注射用药物配制和给药阶段差错发生率较高。为优化新生儿护理并降低用药差错风险，已通过建立质量保证体系采取纠正措施，该体系包括制定注射用药物配制程序、引入标签系统及开展员工培训。
