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麻醉科住院医师和教师的药物计算错误:相关因素分析。

Drug Calculation Errors in Anesthesiology Residents and Faculty: An Analysis of Contributing Factors.

机构信息

From the Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York.

Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York.

出版信息

Anesth Analg. 2019 Jun;128(6):1292-1299. doi: 10.1213/ANE.0000000000004013.

Abstract

BACKGROUND

Limited data exist regarding computational drug error rates in anesthesia residents and faculty. We investigated the frequency and magnitude of computational errors in a sample of anesthesia residents and faculty.

METHODS

With institutional review board approval from 7 academic institutions in the United States, a 15-question computational test was distributed during rounds. Error rates and the magnitude of the errors were analyzed according to resident versus faculty, years of practice (or residency training), duration of sleep, type of question, and institution.

RESULTS

A total of 371 completed the test: 209 residents and 162 faculty. Both groups committed 2 errors (median value) per test, for a mean error rate of 17.0%. Twenty percent of residents and 25% of faculty scored 100% correct answers. The error rate for postgraduate year 2 residents was less than for postgraduate year 1 (P = .012). The error rate for faculty increased with years of experience, with a weak correlation (R = 0.22; P = .007). The error rates were independent of the number of hours of sleep. The error rate for percentage-type questions was greater than for rate, dose, and ratio questions (P = .001). The error rates varied with the number of operations needed to calculate the answer (P < .001). The frequency of large errors (100-fold greater or less than the correct answer) by residents was twice that of faculty. Error rates varied among institutions ranged from 12% to 22% (P = .021).

CONCLUSIONS

Anesthesiology residents and faculty erred frequently on a computational test, with junior residents and faculty with more experience committing errors more frequently. Residents committed more serious errors twice as frequently as faculty.

摘要

背景

关于麻醉住院医师和教员在计算药物方面的错误率,相关数据有限。我们调查了一组麻醉住院医师和教员的计算错误的频率和程度。

方法

在美国 7 个学术机构的机构审查委员会批准下,在轮班期间分发了一份包含 15 个问题的计算测试。根据住院医师与教员、实践年限(或住院医师培训年限)、睡眠时间、问题类型和机构,分析错误率和错误的严重程度。

结果

共有 371 人完成了测试:209 名住院医师和 162 名教员。两组人均每测试犯 2 个错误(中位数),平均错误率为 17.0%。20%的住院医师和 25%的教员得分为 100%正确答案。第 2 年住院医师的错误率低于第 1 年(P =.012)。教员的经验年限与错误率呈正相关(R = 0.22;P =.007)。睡眠时间与错误率无关。百分比类型问题的错误率大于速率、剂量和比值问题(P =.001)。计算答案所需的操作次数与错误率相关(P <.001)。住院医师的大错误(比正确答案大或小 100 倍)的频率是教员的两倍。各机构的错误率从 12%到 22%不等(P =.021)。

结论

麻醉住院医师和教员在计算测试中经常犯错,经验较少的住院医师和教员更频繁地犯错。住院医师犯严重错误的频率是教员的两倍。

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