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通过在普通病房住院期间进行用药史评估来检测用药错误。

Detection of Medication Errors Through Medication History Assessment During Admission at General Medical Wards.

机构信息

Department of Pharmacy, 58986Sarawak General Hospital, Ministry of Health, Sarawak, Malaysia.

出版信息

J Pharm Pract. 2022 Jun;35(3):407-412. doi: 10.1177/0897190020987127. Epub 2021 Jan 12.

DOI:10.1177/0897190020987127
PMID:33433248
Abstract

INTRODUCTION

Medication history assessment during hospital admissions is an important element in the medication reconciliation process. It ensures continuity of care and reduces medication errors.

OBJECTIVES

This study aimed to determine the incidence of unintentional discrepancies (medication errors), types of medication errors with its potential severity of patient harm and acceptance rate of pharmaceutical care interventions.

METHODS

A four-month cross-sectional study was conducted in the general medical wards of a tertiary hospital. All newly admitted patients with at least one prescription medication were recruited via purposive sampling. Medication history assessments were done by clinical pharmacists within 24 hours or as soon as possible after admission. Pharmacist-acquired medication histories were then compared with in-patient medication charts to detect discrepancies. Verification of the discrepancies, interventions, and assessment of the potential severity of patient harm resulting from medication errors were collaboratively carried out with the treating doctors.

RESULTS

There were 990 medication discrepancies detected among 390 patients recruited in this study. One hundred and thirty-five (13.6%) medication errors were detected in 93 (23.8%) patients (1.45 errors per patient). These were mostly contributed by medication omissions (79.3%), followed by dosing errors (9.6%). Among these errors, 88.2% were considered "significant" or "serious" but none were "life-threatening." Most (83%) of the pharmaceutical interventions were accepted by the doctors.

CONCLUSION

Medication history assessment by pharmacists proved vital in detecting medication errors, mostly medication omissions. Majority of the errors intervened by pharmacists were accepted by the doctors which prevented potential significant or serious patient harm.

摘要

简介

在住院期间评估用药史是药物治疗一致性核对过程中的一个重要环节。它可以确保治疗的连续性,减少用药错误。

目的

本研究旨在确定非故意差异(用药错误)的发生率、用药错误的类型及其对患者伤害的潜在严重程度,以及药物治疗干预的接受率。

方法

这是一项在一家三级医院的普通内科病房进行的为期四个月的横断面研究。通过目的性抽样,招募了所有至少有一张处方药物的新入院患者。临床药师在入院后 24 小时内或尽快进行用药史评估。然后将药师获得的用药史与住院患者用药图表进行比较,以发现差异。与主治医生共同对差异进行核实、干预,并评估用药错误对患者造成的潜在严重程度。

结果

在招募的 390 名患者中,共发现 990 处用药差异。在 93 名(23.8%)患者中发现了 135 项(13.6%)用药错误(每位患者 1.45 个错误)。这些错误主要由用药遗漏(79.3%)引起,其次是剂量错误(9.6%)。这些错误中,88.2%被认为是“显著”或“严重”的,但没有“危及生命”的。大多数(83%)药师的干预措施得到了医生的认可。

结论

药师进行用药史评估在发现用药错误方面非常重要,其中大部分是用药遗漏。药师干预的大多数错误都得到了医生的认可,从而防止了潜在的显著或严重的患者伤害。

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