Matti Nadine, Nguyen Minh-Nha R, Mosel Cassandra, Grzeskowiak Luke E
SA Pharmacy, Flinders Medical Centre, Bedford Park, SA, Australia.
Adelaide Medical School, The Robinson Research Institute, University of Adelaide, Level 6, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA 5000, Australia.
Ther Adv Drug Saf. 2018 Sep 12;9(11):609-617. doi: 10.1177/2042098618796952. eCollection 2018 Nov.
Medication errors are common in neonatal care and can lead to significant harm. We sought to explore utilization of various medication error prevention strategies across Australian and New Zealand neonatal units (NNUs) through a clinical practice survey.
An electronic survey was distributed in October 2016 to relevant staff at each of the 29 level III NNUs identified as members of the Australian and New Zealand Neonatal Network (ANZNN). The survey contained questions relating to a range of medication error prevention strategies identified from a previous systematic review on the topic. The evaluated interventions targeted different aspects of the medication-use process including prescribing, evaluation/checking of orders by clinical pharmacists, transmission, preparation and dispensing of orders, storage of medications, and medication administration.
From the 20 respondents, the evidence-based strategies most commonly utilized were use of smart pumps ( = 18; 90%), and ward-based clinical pharmacists ( = 17; 85%). Interventions least commonly utilized included barcode scanning with medication administration ( = 0; 0%), electronic prescribing and clinical decision support ( = 1; 5%), and dedicated medication administration nurse ( = 2; 10%). The total number of evidence-based medication error prevention strategies utilized in each NNU ranged from 2 to 10 (median = 7), 10 of 16 strategies were utilized by less than 50% of NNUs.
While evidence supports utilization of a number of medication error prevention strategies, these appear inconsistently utilized across current practice settings.
用药错误在新生儿护理中很常见,可能导致严重伤害。我们试图通过一项临床实践调查,探索澳大利亚和新西兰新生儿重症监护病房(NNUs)对各种用药错误预防策略的应用情况。
2016年10月,向被确定为澳大利亚和新西兰新生儿网络(ANZNN)成员的29家三级新生儿重症监护病房的相关工作人员发放了电子调查问卷。该调查包含了与先前关于该主题的系统评价中确定的一系列用药错误预防策略相关的问题。评估的干预措施针对用药过程的不同方面,包括处方开具、临床药师对医嘱的评估/核对、医嘱的传递、准备和调配、药品储存以及给药。
在20名受访者中,最常用的循证策略是使用智能泵(n = 18;90%)和病房临床药师(n = 17;85%)。最不常用的干预措施包括给药时的条形码扫描(n = 0;0%)、电子处方和临床决策支持(n = 1;5%)以及专职给药护士(n = 2;10%)。每个新生儿重症监护病房使用的循证用药错误预防策略总数在2至10种之间(中位数 = 7),16种策略中有10种被不到50%的新生儿重症监护病房使用。
虽然有证据支持使用多种用药错误预防策略,但在当前的实践环境中,这些策略的应用似乎并不一致。