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使用完整的用药史在精神科住院时识别和纠正医疗照护转接中的用药错误。

Use of complete medication history to identify and correct transitions-of-care medication errors at psychiatric hospital admission.

机构信息

Department of Pharmacy, McLean Hospital, Belmont, Massachusetts, United States of America.

Applied Clinical Research Division, DrFirst.COM, Inc., Rockville, Maryland, United States of America.

出版信息

PLoS One. 2023 Jan 25;18(1):e0279903. doi: 10.1371/journal.pone.0279903. eCollection 2023.

DOI:10.1371/journal.pone.0279903
PMID:36696376
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9876239/
Abstract

Methods for categorizing the scale and severity of medication errors corrected by pharmacy staff during admission medication reconciliation using complete medication history continue to evolve. We established a rating scale that is effective for generating error reports to health system quality leadership. These reports are needed to quantify the value of investment in transitions-of-care pharmacy staff. All medication errors that were reported by pharmacy staff in the admission medication reconciliation process during a period of 6 months were eligible for inclusion. Complete medication history data source was utilized by admitting providers and all pharmacist staff and a novel medication error scoring methodology was developed. This methodology included: medication error category, medication error type, potential medication error severity, and medication non-adherence. We determined that 82 medication errors were detected from 72 patients and assessed that 74 of these errors may have harmed patients if they were not corrected through pharmacist intervention. Most of these errors were dosage discrepancies and omissions. With hospital system budgets continually becoming leaner, it is important to measure the effectiveness and value of staff resources to optimize patient care. Pharmacists performing admission medication reconciliation can detect subtle medication discrepancies that may be overlooked by other clinician types. This methodology can serve as a foundation for error reporting and predicting the severity of adverse drug events.

摘要

方法用于分类药物错误的规模和严重程度由药剂师在入院药物重整过程中使用完整的药物史继续发展。我们建立了一个评级量表,可有效地生成向卫生系统质量领导层的错误报告。这些报告是量化在过渡护理药剂师投资价值所必需的。在 6 个月期间,由入院提供者和所有药剂师工作人员利用完整的药物史数据源报告了所有药物错误,并且开发了一种新的药物错误评分方法。该方法包括:药物错误类别、药物错误类型、潜在药物错误严重程度和药物不依从性。我们从 72 名患者中确定了 82 个药物错误,并评估如果不通过药剂师干预纠正,其中 74 个错误可能会伤害患者。这些错误大多是剂量差异和遗漏。随着医院系统预算不断减少,衡量员工资源的有效性和价值以优化患者护理非常重要。进行入院药物重整的药剂师可以检测到其他临床医生类型可能忽略的细微药物差异。该方法可作为错误报告和预测药物不良事件严重程度的基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c26/9876239/7b446051efea/pone.0279903.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c26/9876239/7b446051efea/pone.0279903.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c26/9876239/7b446051efea/pone.0279903.g001.jpg

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