Psychiatry, Hokutokai Sawa Byoin, Toyonaka, Osaka, Japan
Psychiatry, Hokutokai Sawa Byoin, Toyonaka, Osaka, Japan.
BMJ Open. 2022 Apr 29;12(4):e055107. doi: 10.1136/bmjopen-2021-055107.
This study aimed to evaluate a biometric palm vein authentication system to prevent medication administration errors in psychiatric hospitals.
This is a pre-post observational study.
Conventionally, the medication was distributed after a double check. We developed and introduced a new medication administration cart in two psychiatric hospitals in Japan, in which each patient-specific drug box had to be electronically opened only by palm vein authentication.
A total of 3444 and 3523 patients were present 18 months before and after introducing the cart, respectively. Of the 212 nurses recruited, 28 were excluded due to a lack of experience with the conventional medication administration system and incomplete questionnaires.
The primary outcome was the efficacy of this system by comparing the incidence of medication administration errors before and after introducing the cart. The secondary outcome was a survey regarding nurses' attitudes toward this system.
After introduction of the new system, the number of medication errors due to misidentification of persons relative to the total number of admitted patients was significantly reduced from 6/3444 to 2/3523 (p<0.0001). Among 184 nurses, 182 responded that anxiety regarding administration errors was either reduced or unchanged using this system. Male nurses reported a greater increase in work burden than female nurses (OR=3.11, 95% CI=1.44 to 6.72). Nurses working in chronic care wards reported greater time pressure than nurses working in emergency wards (OR=3.33, 95% CI=1.16 to 9.57). Nurses working in dementia care wards reported a greater patient care burden than nurses working in emergency wards (OR=5.67, 95% CI=1.22 to 26.27).
This new system might have potential for reducing the patient misidentification risk during medication without increasing the anxiety experienced by nurses concerning administration errors. However, system usability and efficiency must be improved to reduce additional work burden, time pressure and patient care burden.
本研究旨在评估一种生物识别掌静脉认证系统，以防止精神病院的用药错误。
这是一项前后观察研究。
传统上，药物在双重检查后分发。我们在日本的两家精神病院开发并引入了一种新的药物管理推车，在这种推车上，每个特定患者的药盒必须通过掌静脉认证才能电子打开。
在引入推车之前和之后的 18 个月，共有 3444 名和 3523 名患者在场。在招募的 212 名护士中，由于缺乏对传统药物管理系统的经验和不完整的问卷，有 28 名被排除在外。
主要结果是通过比较引入推车前后药物管理错误的发生率来评估该系统的疗效。次要结果是一项关于护士对该系统态度的调查。
在引入新系统后，相对于入院患者总数，因人员识别错误导致的用药错误数量从 6/3444 显著减少到 2/3523（p<0.0001）。在 184 名护士中，有 182 名护士表示使用该系统后，对给药错误的焦虑感减轻或不变。男护士比女护士报告工作负担增加更多（OR=3.11，95%CI=1.44 至 6.72）。在慢性病病房工作的护士比在急症病房工作的护士报告的时间压力更大（OR=3.33，95%CI=1.16 至 9.57）。在痴呆症病房工作的护士比在急症病房工作的护士报告的患者护理负担更大（OR=5.67，95%CI=1.22 至 26.27）。
这种新系统可能有潜力降低用药过程中的患者身份识别风险，同时不会增加护士对给药错误的焦虑感。然而，必须提高系统的可用性和效率，以减轻额外的工作负担、时间压力和患者护理负担。
