改善急诊科出院患者抗凝治疗的起始安全性。
Improving the safety of anticoagulation initiation in patients discharged from the emergency department.
机构信息
Pharmacy Department, Austin Health, Melbourne, Victoria, Australia.
Emergency Department, Austin Health, Melbourne, Victoria, Australia.
出版信息
Emerg Med Australas. 2023 Feb;35(1):162-164. doi: 10.1111/1742-6723.14104. Epub 2022 Oct 25.
OBJECTIVE
To improve the safety of anticoagulation initiation by increasing the proportion of patients reviewed by a pharmacist.
METHODS
An electronic intervention was developed to ensure all patients prescribed anticoagulation on discharge were reviewed by an ED pharmacist. Safe anticoagulation initiation was compared for patients seen and not seen.
RESULTS
The intervention increased the number of patients seen by an ED pharmacist. Pre-intervention (n = 238) 84.5% of patients were reviewed by a pharmacist. Post-intervention (n = 253) 99.6% of patients were reviewed by a pharmacist. Of the 38 patients not reviewed by a pharmacist, 20 (52.6%) had safe anticoagulation initiation and in a sample of 40 patients reviewed by a pharmacist, all 40 (100%) had safe anticoagulation initiation (52.6% vs 100%, P < 0.001).
CONCLUSION
The real-time electronic intervention improved the number of patients reviewed by a pharmacist. ED pharmacist reviewed patients were more likely to have safe anticoagulation initiation.
目的
通过增加药师审查患者的比例，提高抗凝起始的安全性。
方法
开发了一种电子干预措施，以确保所有在出院时开具抗凝药物的患者都由 ED 药师进行审查。对接受和未接受药师审查的患者的安全抗凝起始情况进行比较。
结果
干预措施增加了 ED 药师审查的患者数量。干预前（n=238），84.5%的患者由药师审查。干预后（n=253），99.6%的患者由药师审查。在未接受药师审查的 38 名患者中，有 20 名（52.6%）的抗凝起始是安全的，而在接受药师审查的 40 名患者中，所有 40 名（100%）的抗凝起始都是安全的（52.6%比 100%，P<0.001）。
结论
实时电子干预措施增加了药师审查的患者数量。接受 ED 药师审查的患者更有可能安全开始抗凝治疗。
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