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运用层次分析法制定用药差错预防策略的优先事项

Priorities in the Prevention Strategies for Medication Error Using the Analytical Hierarchy Process Method.

作者信息

Kim Siin, Kim Hyungtae, Suh Hae Sun

机构信息

College of Pharmacy, Kyung Hee University, Seoul 02447, Korea.

College of Pharmacy, Pusan National University, Busan 46241, Korea.

出版信息

Healthcare (Basel). 2022 Mar 11;10(3):512. doi: 10.3390/healthcare10030512.

Abstract

As medication error is inherently "preventable", we should try to minimize errors to improve patient safety and quality of care. The aim of this study was to prioritize strategies to prevent medication errors using the analytic hierarchy process (AHP) method. The hierarchy structure consisted of three stages: goal of the decision, decision criteria, and alternatives. Ten experts of patient safety research or clinical pharmacology compared each pair of criteria and alternatives and assigned a nine-point numerical scale. We used the eigenvector method to aggregate the pairwise comparisons obtained from experts and to estimate the weights of each criterion and alternative. Among the decision criteria, system improvement in reporting was the most preferred criterion, followed by cultural improvement and system improvement in the counterplan. The preferred alternative was a counterplan by healthcare institutions, followed by a change from a blame culture to safety culture and the building of a reporting system. A sensitivity analysis indicated that priorities were generally robust in the methods used for calculating the integrated matrices. We have suggested the priority of preventive strategies against medication errors using the AHP method. The prioritization of preventive strategies could help policymakers understand current needs and therefore develop evidence-based policies on patient safety.

摘要

由于用药错误本质上是“可预防的”,我们应努力将错误降至最低,以提高患者安全和护理质量。本研究的目的是使用层次分析法(AHP)对预防用药错误的策略进行优先级排序。层次结构由三个阶段组成:决策目标、决策标准和备选方案。十位患者安全研究或临床药理学专家对每对标准和备选方案进行比较,并分配一个九点数字量表。我们使用特征向量法汇总从专家那里获得的成对比较结果,并估计每个标准和备选方案的权重。在决策标准中,报告方面的系统改进是最优先考虑的标准,其次是文化改进和应对计划中的系统改进。首选的备选方案是医疗机构的应对计划,其次是从责备文化转变为安全文化以及建立报告系统。敏感性分析表明,在用于计算综合矩阵的方法中,优先级总体上是稳健的。我们使用层次分析法提出了预防用药错误的策略优先级。预防策略的优先级排序有助于政策制定者了解当前需求,从而制定基于证据的患者安全政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/8950160/99b633f25f0c/healthcare-10-00512-g001.jpg

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