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巴基斯坦奎达地区肾病患者用药错误评估。

Evaluation of medication errors in patients with kidney diseases in Quetta, Pakistan.

机构信息

Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan.

Provincial Drug Testing Laboratory Balochitan, Quetta, Pakistan.

出版信息

PLoS One. 2023 Aug 2;18(8):e0289148. doi: 10.1371/journal.pone.0289148. eCollection 2023.

Abstract

BACKGROUND

Medication errors represent a significant challenge in healthcare, as they can lead to enduring harm for patients and impose substantial financial burdens on the healthcare system. To effectively mitigate medication errors, it is imperative to gain a comprehensive understanding of their frequency and the contributing variables. Thus, the primary objective of this study was to evaluate the occurrence of medication errors among patients with kidney diseases in Quetta, Pakistan.

METHODS

The objective of this study was to assess medication errors in patients diagnosed with kidney diseases in Quetta, Pakistan. The research was conducted at the Balochistan Institute of Nephro-Urology Quetta (BINUQ) Hospital, which serves as a tertiary care center specializing in the treatment of kidney diseases. A cross-sectional descriptive study design was employed over a period of six months. The study population consisted of patients admitted to the Nephro-urology wards at BINUQ Hospital during the specified duration. Data collection encompassed various methodologies, including checklist-guided observation, review of prescription order forms, documentation of drug administration, and comprehensive analysis of patient medical records. Descriptive and analytical analyses were conducted using SPSS version 23. Univariate analysis was employed to identify independent variables associated with medication errors, employing a significance level of p<0.01. The multivariate logistic regression analysis incorporated variables that exhibited a significant association with medication errors during the univariate analysis. Only those variables demonstrating a p-value of less than 0.05 at a 95% confidence level were considered significant predictors of medication administration errors within the final multivariate model.

RESULTS

Among the 274 medication errors identified in the study, documentation errors accounted for 118 cases (12.06%), administration errors for 97 cases (9.91%), prescribing errors for 34 cases (3.47%), and dispensing errors for 25 cases (2.55%). Statistical analysis revealed significant associations (p<0.05) between forgetfulness and duty shift, and medication errors in the documentation process. Similarly, inattention was significantly associated (p<0.05) with both prescribing and dispensing errors. Furthermore, the number of medications received emerged as the most influential factor associated with medication errors. Patients receiving 4-6 medications exhibited an odds ratio of 9.08 (p<0.001) compared to patients receiving 1-3 medications, while patients receiving more than 6 medications had an odds ratio of 4.23 (p<0.001) in relation to patients receiving 1-3 medications.

CONCLUSION

In conclusion, this study determined that documentation errors were the most prevalent medication errors observed in patients with kidney disease in Quetta, Pakistan. Forgetfulness and duty shift were associated with documentation errors, whereas inattention was linked to prescribing and dispensing errors. The significant risk factor for medication errors was found to be a high number of prescribed medications. Therefore, strategies aimed at reducing medication errors should prioritize enhancements in documentation practices, alleviating medication burden, and increasing awareness among healthcare providers.

摘要

背景

药物错误是医疗保健领域的重大挑战,因为它们会给患者带来持久的伤害,并给医疗系统带来巨大的经济负担。为了有效减少药物错误,必须全面了解其发生频率和相关变量。因此,本研究的主要目的是评估巴基斯坦奎达肾病患者的药物错误发生情况。

方法

本研究旨在评估巴基斯坦奎达肾病患者的药物错误。该研究在俾路支省肾病泌尿科奎达(BINUQ)医院进行,该医院是一家专门治疗肾脏疾病的三级护理中心。采用横断面描述性研究设计,为期六个月。研究人群包括在指定时间内在 BINUQ 医院肾泌尿科病房住院的患者。数据收集包括检查表引导观察、处方医嘱表审查、药物管理记录以及患者病历的综合分析等多种方法。使用 SPSS 版本 23 进行描述性和分析性分析。采用单变量分析确定与药物错误相关的独立变量,采用 p<0.01 的显著性水平。多变量逻辑回归分析纳入了在单变量分析中与药物错误有显著关联的变量。仅在 95%置信水平下 p 值小于 0.05 的变量被认为是最终多变量模型中药物管理错误的显著预测因子。

结果

在研究中发现的 274 例药物错误中,有 118 例(12.06%)为文件记录错误,97 例(9.91%)为给药错误,34 例(3.47%)为处方错误,25 例(2.55%)为配药错误。统计分析显示,在文件记录过程中,健忘和轮班与药物错误之间存在显著关联(p<0.05)。同样,注意力不集中与处方和配药错误显著相关(p<0.05)。此外,接受的药物数量是与药物错误最相关的因素。与接受 1-3 种药物的患者相比,接受 4-6 种药物的患者的药物错误比值比(OR)为 9.08(p<0.001),而接受超过 6 种药物的患者的 OR 为 4.23(p<0.001)。

结论

综上所述,本研究确定在巴基斯坦奎达肾病患者中,文件记录错误是最常见的药物错误。健忘和轮班与文件记录错误有关,而注意力不集中与处方和配药错误有关。药物错误的显著危险因素是开处方的药物数量较多。因此,旨在减少药物错误的策略应优先加强文件记录实践,减轻药物负担,并提高医疗保健提供者的意识。

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