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埃塞俄比亚西部内克梅特专科医院内科病房住院成人的用药差错:一项前瞻性观察研究

Medication Errors Among Hospitalized Adults in Medical Wards of Nekemte Specialized Hospital, West Ethiopia: A Prospective Observational Study.

作者信息

Gebre Mohammed, Addisu Nigatu, Getahun Ayantu, Workye Jenber, Gamachu Busha, Fekadu Ginenus, Tekle Tesfa, Wakuma Bizuneh, Fetensa Getahun, Mosisa Balisa, Bayisa Getu

机构信息

Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Department of Pharmacy, College of Health and Medical Sciences, Dilla University, Dilla, Ethiopia.

出版信息

Drug Healthc Patient Saf. 2021 Nov 8;13:221-228. doi: 10.2147/DHPS.S328824. eCollection 2021.

Abstract

PURPOSE

A high prevalence of medication errors in older adults are due to a combination of different factors such as polypharmacy, polymorbidity, enrolment in several disease-management programs, and fragmentation of care that causes medication errors in all age groups. This study aims to assess the incidence and determinants of medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital (NSH), West Ethiopia.

PATIENTS AND METHODS

A prospective observational study design was conducted at Nekemte Specialized Hospital among hospitalized adults from October 30, 2018 to January 30, 2019. Data were collected by using checklist-guided observation and review of medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, logistic regression analysis was used. Statistical significance was considered at a -value <0.05.

RESULTS

A total of 351 patients were included in the present study. The mean age of the patients was 40.67+15.78 years. A total of 813 medication errors were recorded. The most common stage for medication errors was physician ordering 263 (32.4%). In the multivariable analysis, age ≥65 years (AOR: 2.54, 95%CI: 1.12-5.75, =0.025), hospital stay ≥7 days (AOR: 2.16, 95%CI: 1.17-3.98, =0.014), number of medication taken (AOR: 1.75, 95%CI: 1.13-2.73, =0.013) and presence of comorbidity (AOR: 1.57, 95%CI: 1.01-2.46, =0.049) had shown statistical significance in predicting medication errors.

CONCLUSION

Medication errors are common at Nekemte Specialized Hospital with an incidence of 48.3 per 100 orders, 231.6 per 100 admissions, and 433.4 per 1000 patient days. In particular, adults with older age, increased hospital stay, a greater number of medications, and presence of comorbidities were at greater risk for medication errors.

摘要

目的

老年人用药错误的高发生率归因于多种不同因素的综合作用,如多重用药、多种疾病并存、参加多个疾病管理项目以及导致所有年龄组用药错误的护理碎片化。本研究旨在评估埃塞俄比亚西部内克姆特专科医院(NSH)内科病房住院成人用药错误的发生率及其决定因素。

患者与方法

于2018年10月30日至2019年1月30日在内克姆特专科医院对住院成人进行了一项前瞻性观察性研究设计。通过使用清单引导观察以及查阅用药医嘱单、用药记录和患者病历收集数据。为确定用药错误的独立预测因素,采用了逻辑回归分析。当P值<0.05时认为具有统计学意义。

结果

本研究共纳入351例患者。患者的平均年龄为40.67±15.78岁。共记录到813例用药错误。用药错误最常见的阶段是医生开医嘱,有263例(32.4%)。在多变量分析中,年龄≥65岁(比值比:2.54,95%置信区间:1.12 - 5.75,P = 0.025)、住院时间≥7天(比值比:2.16,95%置信区间:1.17 - 3.98,P = 0.014)、用药数量(比值比:1.75,95%置信区间:1.13 - 2.73,P = 0.013)以及存在合并症(比值比:1.57,95%置信区间:1.01 - 2.46,P = 0.049)在预测用药错误方面显示出统计学意义。

结论

在内克姆特专科医院,用药错误很常见,发生率为每100条医嘱48.3例、每100次入院231.6例以及每1000个患者日433.4例。特别是年龄较大、住院时间延长、用药数量较多以及存在合并症的成年人发生用药错误的风险更高。

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