骨科住院单元入院时药剂师辅助电子处方开具及其对用药错误的影响：一项干预前后研究。
Pharmacist-assisted electronic prescribing at the time of admission to an inpatient orthopaedic unit and its impact on medication errors: a pre- and postintervention study.
作者信息
Tran Tim, Taylor Simone E, Hardidge Andrew, Mitri Elise, Aminian Parnaz, George Johnson, Elliott Rohan A
机构信息
Pharmacy Department, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia.
出版信息
Ther Adv Drug Saf. 2019 Jul 12;10:2042098619863985. doi: 10.1177/2042098619863985. eCollection 2019.
BACKGROUND
Prescribing and administration errors related to pre-admission medications are common amongst orthopaedic inpatients. Postprescribing medication reconciliation by clinical pharmacists after hospital admission prevents some but not all errors from reaching the patient. Involving pharmacists at the prescribing stage may more effectively prevent errors. The aim of the study was to evaluate the effect of pharmacist-assisted electronic prescribing at the time of hospital admission on medication errors in orthopaedic inpatients.
METHODS
A pre- and postintervention study was conducted in the orthopaedic unit of a major metropolitan Australian hospital. During the 10-week intervention phase, a project pharmacist used electronic prescribing to assist with prescribing admission medications and postoperative venous thromboembolism (VTE) prophylaxis, in consultation with orthopaedic medical officers. The primary endpoint was the number of medication errors per patient within 72 h of admission. Secondary endpoints included the number and consequence of adverse events (AEs) associated with admission medication errors and the time delay in administering VTE prophylaxis after elective surgery (number of hours after recommended postoperative dose-time).
RESULTS
A total of 198 and 210 patients, pre- and postintervention, were evaluated, respectively. The median number of admission medication errors per patient declined from six pre-intervention to one postintervention ( < 0.01). A total of 17 AEs were related to admission medication errors during the pre-intervention period compared with 1 postintervention. There were 54 and 63 elective surgery patients pre- and postintervention, respectively. The median delay in administering VTE prophylaxis for these patients declined from 9 h pre-intervention to 2 h postintervention ( < 0.01).
CONCLUSIONS
Pharmacist-assisted electronic prescribing reduced the number of admission medication errors and associated AEs.
背景
与入院前用药相关的处方和给药错误在骨科住院患者中很常见。临床药师在患者入院后进行的处方后用药核对可防止部分但并非所有错误传递给患者。在处方阶段让药师参与可能更有效地预防错误。本研究的目的是评估入院时药师协助的电子处方对骨科住院患者用药错误的影响。
方法
在澳大利亚一家主要城市医院的骨科病房进行了一项干预前后的研究。在为期10周的干预阶段，一名项目药师在与骨科医生协商后，使用电子处方协助开具入院用药和术后静脉血栓栓塞（VTE）预防药物。主要终点是入院72小时内每位患者的用药错误数量。次要终点包括与入院用药错误相关的不良事件（AE）的数量和后果，以及择期手术后给予VTE预防药物的时间延迟（推荐术后给药时间后的小时数）。
结果
分别对干预前的198例患者和干预后的210例患者进行了评估。每位患者入院用药错误的中位数从干预前的6个降至干预后的1个（<0.01）。干预前期共有17例AE与入院用药错误相关，而干预后为1例。干预前和干预后分别有54例和6
Zotero 插件