Abuelsoud Nermeen
Department of Clinical Pharmacy Practice, Faculty of Pharmacy, The British University in Egypt, Misr-Ismalia Road, Postal No. 11837, P.O. Box 43, El Sherouk City, Cairo, Egypt.
Ir J Med Sci. 2019 May;188(2):591-600. doi: 10.1007/s11845-018-1860-8. Epub 2018 Jul 14.
Improvement in the quality of the medication management process is a crucial component of twenty-first-century medicine.
To improve the quality of medication management process within pediatric specialty through designing a quality improvement project for the pharmaceutical care services in a children' hospital to solve the drug-related problems during drug prescribing, administration, and monitoring.
A total of 900 medical files were evaluated (100 file/month) from the pediatric medical ward to detect any medication errors during prescribing, administration, or monitoring of the drugs. Three pharmacy quality indicators were designed to detect any medication errors during prescribing, administration, or monitoring of the drugs, then a collective datasheet was designed to record any defect in the system during drug management process within the hospital. A quality improvement project was designed using many quality improvement techniques to decrease the rates of medication errors in each drug handling stage. Brainstorming, fishbone chart, questionnaire, and voting were the main quality tools used to detect the causes of medication errors problem in pediatric patients. Certain actions were implemented which included educational program, implementation of clinical pharmacy, intravenous admixture, and drug information services.
The quality improvement interventions succeeded in decreasing the rates of medication errors in each stage. These interventions succeeded in decreasing the rates of medication errors in prescribing, administration, and monitoring stages from 47, 60, and 56% respectively to ≤ 15% within 9 months.
Pharmacists can have a key role in improving the health-care system's quality in developing countries' health-care systems.
提高药物管理流程的质量是21世纪医学的关键组成部分。
通过为一家儿童医院的药学服务设计一个质量改进项目，以解决药物处方、给药和监测过程中的药物相关问题，从而提高儿科专科的药物管理流程质量。
从儿科病房共评估了900份病历（每月100份），以检测药物处方、给药或监测过程中的任何用药错误。设计了三个药学质量指标来检测药物处方、给药或监测过程中的任何用药错误，然后设计了一个汇总数据表来记录医院内药物管理过程中系统的任何缺陷。使用多种质量改进技术设计了一个质量改进项目，以降低每个药物处理阶段的用药错误率。头脑风暴、鱼骨图、问卷调查和投票是用于检测儿科患者用药错误问题原因的主要质量工具。实施了一些措施，包括教育项目、临床药学的实施、静脉药物配置和药物信息服务。
质量改进干预措施成功降低了每个阶段的用药错误率。这些干预措施成功地将处方、给药和监测阶段的用药错误率分别从47%、60%和56%降至9个月内的≤15%。
在发展中国家的医疗保健系统中，药剂师在提高医疗保健系统质量方面可以发挥关键作用。
