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沙特阿拉伯一家大型三级保健系统中成年患者的处方错误。

Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia.

机构信息

From the Department of Pharmaceutical Services, King Saud Medical City, Riyadh, Saudi Arabia.

From the College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia.

出版信息

Ann Saudi Med. 2021 May-Jun;41(3):147-156. doi: 10.5144/0256-4947.2021.147. Epub 2021 Jun 1.

Abstract

BACKGROUND

Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain.

OBJECTIVE

Assess the prevalence, type, severity, and factors associated with prescribing errors.

DESIGN

Retrospective database review.

SETTING

Large tertiary care setting in Riyadh.

PATIENTS AND METHODS

We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018.

MAIN OUTCOME MEASURE

The prevalence of prescribing errors and associated factors among adult patients.

SAMPLE SIZE

315 166 prescriptions screened.

RESULTS

Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, <.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, <.01).

CONCLUSION

Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors.

LIMITATIONS

Polypharmacy was not considered; the data are from a single healthcare system.

CONFLICT OF INTEREST

None.

摘要

背景

多项研究调查了沙特阿拉伯医院的用药错误;然而,关于处方错误和相关因素的流行数据仍不确定。

目的

评估处方错误的发生率、类型、严重程度和相关因素。

设计

回顾性数据库研究。

设置

利雅得的大型三级保健机构。

患者和方法

我们描述和分析了 2017 年 1 月至 2018 年 12 月期间,来自用药错误电子报告表数据库的两年期间,成人(>14 岁)处方错误相关数据。

主要观察指标

成人患者处方错误的发生率和相关因素。

样本量

筛选了 315166 张处方。

结果

在所筛选的住院和门诊处方总数中,共发现 4934 例处方错误,发生率为 1.56%。最常见的处方错误类型是剂量不当(n=1516;30.7%)和频率不当(n=987;20.0%)。三分之二的处方错误对患者没有造成任何伤害。大多数处方错误是由住院医师(n=2577;52%)造成的,其次是专科医生(n=1629;33%)。处方错误与缺乏记录临床信息(调整后优势比:14.1;95%CI 7.7-16.8,<0.001)和开抗感染药物(调整后优势比 2.9;95%CI 1.3-5.7,<0.01)相关。

结论

电子病历记录不充分和开抗感染药物是预测处方错误的最常见因素。未来的研究应重点测试控制这些因素及其对减少处方错误影响的创新措施。

局限性

未考虑多种药物治疗;数据来自单一医疗保健系统。

利益冲突

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88ce/8176371/0c187019a5cd/0256-4947.2021.147-fig1.jpg

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