Tong Erica Y, Hua Phuong U, Edwards Gail, Van Dyk Eleanor, Yip Gary, Mitra Biswadev, Dooley Michael J
Pharmacy Department, Alfred Health, Melbourne, Vic., Australia.
General Medicine, Alfred Health, Melbourne, Vic., Australia.
Aust J Rural Health. 2022 Jul 8. doi: 10.1111/ajr.12895.
Errors in hospital medication charts are commonly encountered and have been associated with morbidity and mortality. This study evaluates the impact of the Partnered Pharmacist Medication Charting (PPMC) model on medication errors in general medical patients admitted to rural and regional hospitals.
DESIGN/METHOD: A prospective cohort study, comparing before and after the introduction of PPMC was conducted in 13 rural and regional health services. This included a 1-month pre-intervention phase and 3-month intervention phase. In the intervention phase, PPMC was implemented as a new model of care in general medical units.
Victoria, Australia.
Patients admitted to General Medical Units.
The proportion of medication charts with at least one error was the primary outcome measure. Secondary outcome measures included inpatient length of stay (LOS), risk stratification of medication errors, Medical Emergency Team (MET) calls, transfers to ICU and hospital readmission.
Of the 669 patients who received standard medical charting during the pre-intervention period, 446 (66.7%) had at least one medication error identified compared to 64 patients (9.5%) using PPMC model (p < 0.001). There were 1361 medication charting errors identified during pre-intervention and 80 in the post-intervention. The median (interquartile range) inpatient length of stay was 4.8 (2.7-10.8) in the pre-intervention and 3.7 days (2.0-7.0) among patients that received PPMC (p < 0.001).
The PPMC model was successfully scaled across rural and regional Victoria as a medication safety strategy. The model was associated with significantly lower rates of medication errors, lower severity of errors and shorter inpatient length of stay.
医院用药记录中的错误屡见不鲜，且与发病率和死亡率相关。本研究评估了药师合作用药记录（PPMC）模式对入住农村和地区医院的普通内科患者用药错误的影响。
设计/方法：在13个农村和地区卫生服务机构开展了一项前瞻性队列研究，比较PPMC引入前后的情况。这包括1个月的干预前阶段和3个月的干预阶段。在干预阶段，PPMC作为普通内科病房的一种新护理模式实施。
澳大利亚维多利亚州。
入住普通内科病房的患者。
至少有一处错误的用药记录比例是主要观察指标。次要观察指标包括住院时间（LOS）、用药错误的风险分层、医疗急救团队（MET）呼叫次数、转入重症监护病房（ICU）情况及再次入院情况。
在干预前期接受标准医疗记录的669例患者中，446例（66.7%）被发现至少有一处用药错误，而使用PPMC模式的64例患者中这一比例为9.5%（p<0.001）。干预前期共发现1361处用药记录错误，干预后期为80处。干预前期患者住院时间的中位数（四分位间距）为4.8天（2.7 - 10.8天），接受PPMC模式的患者为3.7天（2.0 - 7.0天）（p<0.001）。
PPMC模式作为一种用药安全策略在维多利亚州农村和地区成功推广。该模式与显著降低的用药错误率、更低的错误严重程度及更短的住院时间相关。
