Bullen Kathryn, Hall Nicola, Sherwood John, Wake Nicola, Donovan Gemma
School of Pharmacy, University of Sunderland, Sunderland, Tyne and Wear, UK.
Pharmacy Department, Northumbria Healthcare NHS Foundation Trust, North Shields, Tyne and Wear, UK.
Integr Healthc J. 2020 Dec 10;2(1):e000026. doi: 10.1136/ihj-2019-000026. eCollection 2020.
Prescribing errors can cause avoidable harm to patients. Most prescriptions originate in primary care, where medications tend to be self-administered and errors have the most potential to cause harm. Reporting prescribing errors can identify trends and reduce the risk of the reoccurrence of incidents; however, under-reporting is common. The organisation of care and the movement of prescriptions from general practice to community pharmacy may create difficulties for professionals to effectively report errors. This review aims specifically to identify primary research studies that examine barriers and facilitators to prescription error reporting across primary care. A systematic research of the literature was completed in July 2019. Four databases (PubMed/Medline, Cochrane, CINAHL and Web of Science) were searched for relevant studies. No date or language limits were applied. Eligible studies were critically appraised using the Mixed Methods Appraisal Tool, and data were descriptively and narratively synthesised. Ten articles were included in the final analysis. Seven studies considered prescription errors and error reporting within general practice and three within a community pharmacy setting. Findings from the included studies are presented across five themes, including definition of an error, prescribing error reporting culture, reporting processes, communication and capacity. Healthcare professionals appreciate the value of prescription error reporting, but there are key barriers to implementation, including time, fear of reprisal and organisation separation within primary care.
处方错误会给患者造成可避免的伤害。大多数处方源自初级医疗保健,在那里药物往往是患者自行服用的,而且错误最有可能造成伤害。报告处方错误能够识别趋势并降低事件再次发生的风险;然而,漏报情况很常见。医疗护理的组织以及处方从全科医疗向社区药房的流转可能给专业人员有效报告错误带来困难。本综述专门旨在识别那些研究初级医疗保健中处方错误报告的障碍和促进因素的原始研究。2019年7月完成了对文献的系统检索。检索了四个数据库(PubMed/Medline、Cochrane、CINAHL和科学网)以查找相关研究。未设置日期或语言限制。使用混合方法评估工具对符合条件的研究进行了严格评估,并对数据进行了描述性和叙述性综合分析。最终分析纳入了十篇文章。七项研究考虑了全科医疗中的处方错误和错误报告,三项研究考虑了社区药房环境中的情况。纳入研究的结果呈现为五个主题,包括错误的定义、处方错误报告文化、报告流程、沟通和能力。医疗保健专业人员认识到处方错误报告的价值,但实施过程中存在关键障碍,包括时间、担心遭到报复以及初级医疗保健内部的组织分隔。