Risør Bettina Wulff, Lisby Marianne, Sørensen Jan
Department of Public Health, Centre for Health Economics Research (COHERE), University of Southern Denmark, Odense C, Denmark.
Hospital Pharmacy, Central Denmark Region, Aarhus C, Denmark.
Eur J Hosp Pharm. 2016 Jul;23(4):189-196. doi: 10.1136/ejhpharm-2015-000749. Epub 2015 Nov 27.
Improvements in a hospital's medication administration process might reduce the prevalence of medication errors and improve patient safety. The objective of this study was to evaluate the success of an automated medication system in reducing medication administration errors.
A controlled before-and-after study with follow-up after 4 months was conducted in two Danish haematological hospital wards. The occurrence of administration errors was observed in two 3-week periods. The error rate was calculated by dividing the number of doses with one or more errors by the number of doses (opportunities for errors). Logistic regression was used to assess changes in error rates after implementation of the automated medication system with time, group, and interaction between time and group as independent variables. The estimated parameter for the interaction term was interpreted as the incremental change ('difference-in-difference') caused by the new dispensing system.
A total of 697 doses with one or more errors were identified out of 2245 doses. The error rate decreased from 0.35 at baseline to 0.17 at follow-up in the intervention ward and from 0.37 to 0.35 in the control ward. The overall risk of errors was reduced by 57% in the intervention ward compared with the control ward (OR 0.43; 95% CI 0.30 to 0.63).
The automated medication system reduced the error rate of the medication administration process and thus improved patient safety in the medication process.
改进医院的给药流程可能会降低用药错误的发生率并提高患者安全性。本研究的目的是评估自动化给药系统在减少给药错误方面的成效。
在丹麦的两个血液科医院病房进行了一项前后对照研究,并在4个月后进行随访。在两个为期3周的时间段内观察给药错误的发生情况。错误率通过将出现一个或多个错误的剂量数除以总剂量数(出错机会)来计算。使用逻辑回归分析,以时间、组以及时间与组之间的交互作用作为自变量,评估自动化给药系统实施后错误率的变化。交互项的估计参数被解释为新配药系统导致的增量变化(“差值中的差值”)。
在2245剂药物中,共识别出697剂存在一个或多个错误。干预病房的错误率从基线时的0.35降至随访时的0.17,而对照病房的错误率从0.37降至0.35。与对照病房相比,干预病房的总体出错风险降低了57%(比值比0.43;95%置信区间0.30至0.63)。
自动化给药系统降低了给药流程的错误率,从而提高了用药过程中的患者安全性。