Faculty of Engineering, The University of Sydney, Camperdown, NSW 2006, Australia.
Digital Health Solutions, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia.
Int J Environ Res Public Health. 2023 Jan 19;20(3):1879. doi: 10.3390/ijerph20031879.
Medication errors at transition of care remain a concerning issue. In recent times, the use of integrated electronic medication management systems (EMMS) has caused a reduction in medication errors, but its effectiveness in reducing medication deviations at transition of care has not been studied in hospital-wide settings in Australia. The aim of this study is to assess medication deviations, such as omissions and mismatches, pre-EMMS and post-EMMS implementation at transition of care across a hospital. In this study, patient records were reviewed retrospectively to identify medication deviations (medication omissions and medication mismatches) at admission and discharge from hospital. A total of 400 patient records were reviewed (200 patients in the pre-EMMS and 200 patients in the post-EMMS group). Out of 400 patients, 112 in the pre-EMMS group and 134 patients in post-EMMS group met the inclusion criteria and were included in the analysis. A total of 105 out of 246 patients (42.7%) had any medication deviations on their medications. In the pre-EMMS group, 59 out of 112 (52.7%) patients had any deviations on their medications compared to 46 out of 134 patients (34.3%) from the post-EMMS group ( = 0.004). The proportion of patients with medication omitted from inpatient orders was 36.6% in the pre-EMMS cohort vs. 22.4% in the post-EMMS cohort ( = 0.014). Additionally, the proportion of patients with mismatches in medications on the inpatient charts compared to their medication history was 4.5% in the pre-EMMS group compared to 0% in the post-EMMS group ( = 0.019). Similarly, the proportion of patients with medications omitted from their discharge summary was 23.2% in the pre-EMMS group vs. 12.7% in the post-EMMS group ( = 0.03). Our study demonstrates a reduction in medication deviations after the implementation of the EMMS in hospital settings.
在医疗保健交接过程中，用药错误仍然是一个令人关注的问题。最近，集成电子用药管理系统（EMMS）的使用减少了用药错误，但在澳大利亚的医院范围内，其在减少医疗保健交接过程中的用药偏差方面的效果尚未得到研究。本研究旨在评估在医院范围内，EMMS 实施前后交接过程中的用药偏差，如遗漏和不匹配。在这项研究中，回顾性地审查了患者记录，以确定入院和出院时的用药偏差（用药遗漏和用药不匹配）。共审查了 400 份患者记录（EMMS 实施前 200 份，EMMS 实施后 200 份）。在 400 名患者中，有 112 名符合 EMMS 实施前组的纳入标准，134 名符合 EMMS 实施后组的纳入标准，纳入分析。共有 246 名患者中的 105 名（42.7%）在用药上有任何用药偏差。在 EMMS 实施前组中，有 59 名（52.7%）患者在用药上有任何偏差，而 EMMS 实施后组中有 46 名（34.3%）患者有任何偏差（ = 0.004）。在 EMMS 实施前组中，有 36.6%的住院医嘱中有用药遗漏，而在 EMMS 实施后组中，这一比例为 22.4%（ = 0.014）。此外，在住院病历中与用药史相比，有 4.5%的患者用药不匹配，而在 EMMS 实施后组中，这一比例为 0%（ = 0.019）。同样，在 EMMS 实施前组中，有 23.2%的患者出院小结中有用药遗漏，而在 EMMS 实施后组中，这一比例为 12.7%（ = 0.03）。我们的研究表明，在医院环境中实施 EMMS 后，用药偏差有所减少。
