Cedars-Sinai Medical Center, Los Angeles, CA, USA.
HonorHealth, Scottsdale, AZ, USA.
Am J Health Syst Pharm. 2023 Apr 19;80(9):e104-e110. doi: 10.1093/ajhp/zxad038.
California Senate Bill (SB) 1254 (effective January 1, 2019) requires pharmacy staff at acute hospitals with more than 100 beds to obtain a medication profile for high-risk patients upon hospital admission. This multicenter study sought to evaluate the statewide impact of California SB 1254 by capturing the errors intercepted and harm prevented as a result of the passage of the bill.
This was a multicenter, prospective, observational study conducted at 11 hospitals in California for 6 consecutive weeks between January 2020 and March 2020. Participating sites captured medication history errors identified among high-risk patients using organization-specific criteria. Errors were categorized by type and ranked for severity of potential or actual harm based on the modified National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) categories.
Study sites had an average daily census of 180 to 800 patients. Approximately 94% (n = 2,554) of medication histories conducted disclosed at least 1 error. Approximately 54% (n = 1,474) of histories disclosed at least 1 serious or potentially life-threatening error. Approximately 6 errors were identified and prevented per patient (95% CI, 5.62-6.01 errors per patient), and 1 in 4 errors (25%) was categorized as potentially serious or life-threatening.
Among high-risk patients, pharmacy-led medication histories significantly reduced medication errors. If not intercepted, these errors would have likely resulted in substantial morbidity and mortality. Future research should evaluate opportunities to standardize high-risk criteria to support patient prioritization and allocation of resources.
加利福尼亚州参议院法案 1254 号（自 2019 年 1 月 1 日起生效）要求拥有 100 张以上病床的急症医院的药剂师在患者入院时获取高风险患者的用药概况。这项多中心研究旨在通过捕捉该法案通过后拦截的错误和预防的伤害，评估加利福尼亚州参议院法案 1254 号的全州影响。
这是一项在加利福尼亚州的 11 家医院进行的多中心、前瞻性、观察性研究，在 2020 年 1 月至 3 月期间连续进行了 6 周。参与的地点使用特定于组织的标准来捕获高风险患者中发现的药物历史错误。根据修改后的国家协调委员会药物错误报告和预防（NCC MERP）类别，根据错误的类型和潜在或实际伤害的严重程度对错误进行分类。
研究地点的日常住院人数平均为 180 至 800 人。大约 94%（n=2554）的药物史记录至少显示 1 个错误。大约 54%（n=1474）的病史记录至少有 1 个严重或潜在危及生命的错误。每个患者识别并预防了大约 6 个错误（95%置信区间，每个患者 5.62-6.01 个错误），四分之一（25%）的错误被归类为潜在严重或危及生命。
在高风险患者中，药房主导的药物史显著减少了药物错误。如果不被拦截，这些错误很可能导致严重的发病率和死亡率。未来的研究应评估标准化高风险标准的机会，以支持患者的优先级和资源的分配。
