Grugnetti Anna Maria, Caruso Rosario, Scognamiglio Domenico, Monti Maria Cristina, Garofalo Cinzia, Monti Maria Cristina, Meles Mauro Oreste, Arrigoni Cristina
IRCCS Policlinic San Matteo Foundation and Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Italy.
Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
G Ital Med Lav Ergon. 2020 Mar;42(1):48-54.
Background. Interruptions occurring during the drug preparation and administration have a documented effect on patients' safety. However, literature has paid little attention to show how the introduction of a set of standardized organizational interventions, based on the combination of the current evidence, could reduce the number of interruptions occurring during drug therapy management. For this reason, this study used the most recent evidence to combine a set of standardized organizational interventions, and it was aimed to assess the effect of those interventions on the number of interruptions occurring during drug therapy management (Hypothesis a) and the overall duration of the therapy administration (Hypothesis b). Methods. A quasi-experimental study was performed, using pre- and a post- organizational implementation data collections in a single Italian center. The data collections were related to the interruptions and 40 shifts were randomly selected for both pre- and post-phase, respectively on December 2016 and February 2017. The standardized organizational interventions were implemented using the current evidence on this topic. Results. The standardized organizational interventions decreased the interruptions in the post-implementation phase, but those had not an effect on the duration of the therapy administration. Conclusions. This study represented an updated evidence, which describes the effect of a standardized and evidence-based set of organisational interventions' implementation on drug therapy management. Our results suggest a number of hints for managers and future researches. Managers should keep into account the usefulness of those interventions, while future researches with experimental designs are needed to provide harder evidence on this topic.
背景。药物准备和给药过程中发生的干扰对患者安全有文献记载的影响。然而，文献很少关注展示基于现有证据组合的一套标准化组织干预措施如何能够减少药物治疗管理期间发生的干扰数量。因此，本研究利用最新证据组合了一套标准化组织干预措施，旨在评估这些干预措施对药物治疗管理期间发生的干扰数量（假设a）和治疗给药总时长（假设b）的影响。方法。在意大利的一个单一中心进行了一项准实验研究，使用组织实施前和实施后的数据收集。数据收集与干扰相关，在2016年12月和2017年2月分别为实施前和实施后阶段随机选择了40个班次。标准化组织干预措施是根据关于该主题的现有证据实施的。结果。标准化组织干预措施在实施后阶段减少了干扰，但对治疗给药时长没有影响。结论。本研究提供了最新证据，描述了一套标准化且基于证据的组织干预措施的实施对药物治疗管理的影响。我们的结果为管理人员和未来研究提供了一些提示。管理人员应考虑这些干预措施的有用性，而未来需要采用实验设计的研究来提供关于该主题更确凿的证据。
