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儿科患者在医院病房之间转科时的用药差异发生率。

Prevalence of medication discrepancies in pediatric patients transferred between hospital wards.

机构信息

Pharmaceutical Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Federal University of Sergipe, São Cristóvão, Brazil.

Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS-UFS), Federal University of Sergipe, São Cristóvão, Brazil.

出版信息

Int J Clin Pharm. 2021 Aug;43(4):909-917. doi: 10.1007/s11096-020-01196-w. Epub 2020 Nov 11.

Abstract

Background Children are more susceptible to harm from medication errors and adverse drug reactions when compared to adults. Such events may occur from medication discrepancies while transitioning patients throughout the healthcare system. Contributing factors include medication discontinuity and lack of information by the healthcare team. Objective To analyze the prevalence of medication discrepancies in transition points of care in a pediatric department. Setting Pediatric department of a public hospital in Northeast Brazil. Method A cross-sectional study was carried out from August 2017 to March 2018. Data collection consisted of the following steps: collection of sociodemographic data, clinical interview with the patient's caregiver, registration of patient prescriptions, and evaluation of medical records. Medication discrepancies were classified as intentional and unintentional. The unintentional medication discrepancies were classified as omission of medication, therapeutic duplicity, and differences in dose, frequency, or route of administration. Main outcomes measure Discrepancy profile identified at admission, internal transfer and hospital discharge. Results Among the 114 patients included in the study, 85 (74.5%) patients had at least one unintentional medication discrepancy, of which 16 (14.0%) patients presented medication discrepancies at hospital admission, 42 (36.8%) patients at internal transfer, and 52 (45.6%) patients during discharge. Omission of medication represented 20 (74.1%) errors at admission, 26 (37.7%) errors at internal transfer, and 80 (100.0%) errors at hospital discharge. Conclusions The main transition points of care where unintentional discrepancies occurred in the studied pediatric department were at internal transfer and hospital discharge, with omission being the most common type of unintentional discrepancy.

摘要

背景

与成人相比,儿童更容易受到用药错误和药物不良反应的伤害。这些事件可能发生在患者在整个医疗系统中转移时的药物差异。促成因素包括药物中断和医疗团队缺乏信息。

目的

分析儿科病房过渡护理点药物差异的发生率。

地点

巴西东北部一家公立医院的儿科病房。

方法

这是一项横断面研究,于 2017 年 8 月至 2018 年 3 月进行。数据收集包括以下步骤:收集社会人口统计学数据、与患者照顾者进行临床访谈、登记患者处方和评估病历。药物差异分为有意和无意。无意的药物差异分为药物遗漏、治疗重复和剂量、频率或给药途径差异。

主要结果测量

入院、内部转移和出院时识别的差异特征。

结果

在纳入研究的 114 名患者中,85 名(74.5%)患者至少存在一次无意药物差异,其中 16 名(14.0%)患者在入院时存在药物差异,42 名(36.8%)患者在内部转移时存在药物差异,52 名(45.6%)患者在出院时存在药物差异。遗漏药物在入院时占 20 个(74.1%)错误,在内部转移时占 26 个(37.7%)错误,在出院时占 80 个(100.0%)错误。

结论

在研究的儿科病房中,无意差异主要发生在内部转移和出院时,遗漏是最常见的无意差异类型。

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