确定成人重症监护病房中的用药错误

Determining Medication Errors in an Adult Intensive Care Unit.

作者信息

Castro Renata da Nóbrega Souza de, Aguiar Lucas Barbosa de, Volpe Cris Renata Grou, Silva Calliandra Maria de Souza, Silva Izabel Cristina Rodrigues da, Stival Marina Morato, Silva Everton Nunes da, Meiners Micheline Marie Milward de Azevedo, Schwerz Funghetto Silvana

机构信息

Graduate Program in Health Sciences and Technologies, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, Brazil.

Department of Nursing, Faculty of Ceilandia, University of Brasília, Federal District, Brasília 72220-275, Brazil.

出版信息

Int J Environ Res Public Health. 2023 Sep 20;20(18):6788. doi: 10.3390/ijerph20186788.

DOI:10.3390/ijerph20186788

PMID:37754646

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10531059/

Abstract

INTRODUCTION

Research addressing the costs of Medication errors (MEs) is still scarce despite issues related to patient safety having significant economic and health impacts, making it imperative to analyze the costs and adverse events related to MEs for a better patient, professional, and institutional safety.

AIM

To identify the number of medication errors and verify whether this number was associated with increased hospitalization costs for patients in an Intensive Care Unit (ICU).

METHOD

This retrospective cross-sectional cohort study evaluated secondary data from patients' electronic medical records to compile variables, create a model, and survey hospitalization costs. The statistical analysis included calculating medication error rates, descriptive analysis, and simple and multivariate regression.

RESULTS

The omission error rate showed the highest number of errors per drug dose (59.8%) and total errors observed in the sample (55.31%), followed by the time error rate (26.97%; 24.95%). The omission error had the highest average when analyzing the entire hospitalization (170.40) and day of hospitalization (13.79). Hospitalization costs were significantly and positively correlated with scheduling errors, with an increase of BRL 121.92 (about USD $25.00) (95% CI 43.09; 200.74), and to prescription errors, with an increase of BRL 63.51 (about USD $3.00) (95% CI 29.93; 97.09).

CONCLUSION

We observed an association between two types of medication errors and increased hospitalization costs in an adult ICU (scheduling and prescription errors).

摘要

引言

尽管与患者安全相关的问题具有重大的经济和健康影响，但针对用药错误（MEs）成本的研究仍然很少，因此有必要分析与用药错误相关的成本和不良事件，以提高患者、专业人员和机构的安全性。

目的

确定用药错误的数量，并验证该数量是否与重症监护病房（ICU）患者住院费用的增加有关。

方法

这项回顾性横断面队列研究评估了患者电子病历中的二级数据，以汇总变量、创建模型并调查住院费用。统计分析包括计算用药错误率、描述性分析以及简单和多元回归。

结果

遗漏错误率显示每剂药物的错误数量最多（59.8%），且在样本中观察到的总错误数最多（55.31%），其次是时间错误率（26.97%；24.95%）。在分析整个住院期间（170.40）和住院日（13.79）时，遗漏错误的平均值最高。住院费用与排班错误显著正相关，增加了121.92巴西雷亚尔（约25.00美元）（95%可信区间43.09；200.74），与处方错误也显著正相关，增加了63.51巴西雷亚尔（约3.00美元）（95%可信区间29.93；97.09）。