Howlett Moninne, McCarthy Suzanne, Silvari Virginia, Franklin Bryony Dean, Laaksonen Raisa
Departments of Pharmacy and Digital Health, Children's Health Ireland, Dublin, Ireland
School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
Eur J Hosp Pharm. 2025 Apr 23;32(3):241-249. doi: 10.1136/ejhpharm-2023-004065.
Medication errors (MEs) are a leading cause of morbidity and mortality in the healthcare system. Patients admitted to intensive care units (ICUs) are potentially more susceptible to MEs due to severity of illness, the complexity of treatments they receive and the challenging nature of the ICU setting. The European Association of Hospital Pharmacists established a Special Interest Group (SIG) to undertake a programme of work to develop and prioritise recommendations to support medication safety improvement in ICUs across Europe.
Initial policy recommendations for medication safety within the ICU environment were developed following reviews of the literature and engagement with relevant stakeholders. A Delphi panel of 21 members of the SIG, that comprised healthcare professionals (HCPs) with expertise in ICU and/or medication safety, was convened in 2022. We conducted two rounds using a modified Delphi technique whereby participants anonymously ranked on a 9-point Likert Scale the policy recommendations according to their priority for implementation.
In total, 32 policy recommendations were developed. In Delphi Round 1, 19 HCPs participated; consensus was achieved on most recommendations and partial consensus on six. In Delphi Round 2, 18 HCPs participated. After two Delphi rounds, consensus was achieved on all 32 recommendations. All recommendations were considered 'high priority' except one that was considered 'medium priority'.
Through this study it was possible to develop and prioritise evidence-based policy recommendations to enhance medication safety, which may contribute to reducing MEs in ICUs across Europe. All recommendations were considered 'high priority' for implementation except one, indicating the perceived value of these recommendations in improving medication safety through preventing MEs in ICUs.
用药错误是医疗系统中发病和死亡的主要原因。由于病情严重、接受的治疗复杂以及重症监护病房（ICU）环境具有挑战性，入住ICU的患者可能更容易发生用药错误。欧洲医院药剂师协会成立了一个特别兴趣小组（SIG），开展一项工作计划，以制定并确定建议的优先顺序，支持欧洲各地ICU改善用药安全。
在对文献进行综述并与相关利益攸关方进行交流之后，制定了关于ICU环境下用药安全的初步政策建议。2022年召集了一个由21名SIG成员组成的德尔菲小组，成员包括在ICU和/或用药安全方面具有专业知识的医疗保健专业人员（HCP）。我们采用改良的德尔菲技术进行了两轮调查，参与者根据政策建议的实施优先级，在9点李克特量表上进行匿名排序。
总共制定了32条政策建议。在德尔菲第一轮中，19名HCP参与；大多数建议达成了共识，6条达成了部分共识。在德尔菲第二轮中，18名HCP参与。经过两轮德尔菲调查，所有32条建议都达成了共识。除了一条被认为是“中等优先级”的建议外，所有建议都被认为是“高优先级”。
通过这项研究，有可能制定并确定基于证据的政策建议以提高用药安全，这可能有助于减少欧洲各地ICU的用药错误。除了一条建议外，所有建议都被认为是实施方面的“高优先级”，这表明这些建议在通过预防ICU用药错误来改善用药安全方面具有可感知的价值。
