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马来西亚一家教学医院与用药错误相关的因素。

Factors Associated With Medication Errors at a Teaching Hospital in Malaysia.

作者信息

Shitu Zayyanu, Moe Thwe Aung Myat, Tuan Kamauzaman Tuan Hairulnizam, Ab Rahman Ab Fatah

机构信息

Hospital Services and Management Board, Ministry of Health, Zamfara State, Nigeria.

Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, Kuala Terengganu, Malaysia.

出版信息

Hosp Pharm. 2021 Aug;56(4):259-264. doi: 10.1177/0018578719890092. Epub 2019 Nov 26.

Abstract

Medication errors (MEs) continue to pose a significant problem to health care systems across the world, not only causing harm and death in patients but also consuming approximately $42 billion annually in health care expenditure. The emergency department (ED) is considered a high-risk area of having MEs to occur. Little is known about the associated factors of ME in the ED of hospitals in Malaysia. The objective of this study was to determine the factors associated with ME in an ED of a teaching hospital. A cross-sectional study was conducted on patients who visited the ED of Hospital Universiti Sains Malaysia over 9 weeks during normal working hours (ie, 8:00 am-5:00 pm). A total of 547 patients who satisfied the inclusion criteria were enrolled for the study. Patient demographic information, clinical characteristics, and medication orders and procedures were observed and recorded. The required number of patient data (n = 311) were selected randomly for analysis. Multiple logistic regression method was employed to determine factors associated with ME. Of the 311 patient data, 95 (30.5%) patients had at least 1 ME. The factors found to be associated with ME were number of medications (adjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.51-2.41), triage (adjusted OR, 0.11; 95% CI, 0.04-0.27), gender (adjusted OR, 0.50; 95% CI, 0.26-0.93), and time of patient visit (adjusted OR, 0.34; 95% CI, 0.52-0.75). Medication error was not uncommon in our ED setting. Patients with a higher number of medications prescribed during visit to the ED were found to be particularly at risk. Identification of such factors may guide intervention measures to prevent MEs in this setting.

摘要

用药错误(MEs)仍然是全球医疗保健系统面临的一个重大问题,不仅会导致患者伤害和死亡,还会使每年的医疗保健支出消耗约420亿美元。急诊科(ED)被认为是发生用药错误的高风险区域。对于马来西亚医院急诊科中用药错误的相关因素,人们知之甚少。本研究的目的是确定一所教学医院急诊科中与用药错误相关的因素。对在正常工作时间(即上午8:00至下午5:00)期间到马来西亚理科大学医院急诊科就诊超过9周的患者进行了一项横断面研究。共有547名符合纳入标准的患者被纳入该研究。观察并记录了患者的人口统计学信息、临床特征以及用药医嘱和程序。随机选择所需数量的患者数据(n = 311)进行分析。采用多元逻辑回归方法确定与用药错误相关的因素。在311例患者数据中,95例(30.5%)患者至少有1次用药错误。发现与用药错误相关的因素有用药数量(调整后的优势比[OR],1.91;95%置信区间[CI],1.51 - 2.41)、分诊(调整后的OR,0.11;95% CI,0.04 - 0.27)、性别(调整后的OR,0.50;95% CI,0.26 - 0.93)以及患者就诊时间(调整后的OR,0.34;95% CI,0.52 - 0.75)。在我们的急诊科环境中,用药错误并不罕见。发现在急诊科就诊期间开具的用药数量较多的患者尤其面临风险。识别这些因素可能有助于指导采取干预措施以预防该环境中的用药错误。

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