McDonald Danielle, Mansukhani Rupal, Kokotajlo Suzannah, Diaz Frank, Robinson Christine
J Pediatr Pharmacol Ther. 2018 May-Jun;23(3):203-208. doi: 10.5863/1551-6776-23.3.203.
This study was conducted to evaluate the impact of education on optimizing medication histories in a single-center pediatric emergency department.
This was a prospective, 2-phase study of 200 patients ages 21 years and younger who presented to the pediatric emergency department in January and February 2017. In phase I of the study, 100 patients were interviewed by both a nurse and a pharmacist. Between phases I and II, the pharmacist educated each nurse and disseminated standardized education materials. In phase II, 100 additional patients were interviewed by both a nurse and a pharmacist. Discrepancies were quantified in both phases of the study. The primary outcome was the distribution of total discrepancies in medications identified. Total discrepancies were defined as a composite of medication name, dose, route, frequency, and time of last dose.
A total of 200 medication histories were collected over phases I and II. In phase I (n = 79), the pharmacist identified 185 medications, 88 of which were also identified by the nurse. In phase II (n = 82), the pharmacist identified 180 medications, 95 of which were also identified by the nurse. The distribution of discrepancies per patient and per medication was significantly reduced in regard to dose, route, and frequency documentation.
Although improvement was observed, barriers beyond a knowledge deficit exist to limit accuracy of medication histories collected by nurses.
本研究旨在评估教育对单中心儿科急诊科优化用药史的影响。
这是一项针对2017年1月和2月到儿科急诊科就诊的200名21岁及以下患者的前瞻性两阶段研究。在研究的第一阶段，由一名护士和一名药剂师对100名患者进行访谈。在第一阶段和第二阶段之间，药剂师对每位护士进行培训并分发标准化教育材料。在第二阶段，另外100名患者由一名护士和一名药剂师进行访谈。在研究的两个阶段中对差异进行量化。主要结果是所识别药物中总差异的分布情况。总差异定义为药物名称、剂量、给药途径、频率和最后一剂时间的综合。
在第一阶段和第二阶段共收集了200份用药史。在第一阶段（n = 79），药剂师识别出185种药物，其中88种也被护士识别出来。在第二阶段（n = 82），药剂师识别出180种药物，其中95种也被护士识别出来。在剂量、给药途径和频率记录方面，每位患者和每种药物的差异分布显著减少。
尽管观察到有所改善，但除了知识不足之外，还存在其他障碍限制护士收集用药史的准确性。
