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电子药物管理系统对入院和出院时药物偏差的影响。

The Impact of an Electronic Medication Management System on Medication Deviations on Admission and Discharge from Hospital.

机构信息

Faculty of Engineering, The University of Sydney, Camperdown, NSW 2006, Australia.

Digital Health Solutions, Western Sydney Local Health District, North Parramatta, NSW 2151, Australia.

出版信息

Int J Environ Res Public Health. 2023 Jan 19;20(3):1879. doi: 10.3390/ijerph20031879.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a621/9915082/231feccbbdc7/ijerph-20-01879-g001.jpg

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