Abdelaziz Shahd, Amigoni Angela, Kurttila Minna, Laaksonen Raisa, Silvari Virginia, Franklin Bryony Dean
Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
Department of Women's and Child's Health, University Hospital of Padova, Padova, Italy.
Eur J Hosp Pharm. 2025 Feb 21;32(2):113-120. doi: 10.1136/ejhpharm-2023-004018.
Patients in intensive care units (ICUs) are potentially more vulnerable to medication errors than patients admitted to general wards. However, little is known about medication safety strategies used in European ICUs. Our objectives were to explore the strategies being used and being planned within European ICUs, to identify areas of variation, and to inform recommendations to improve medication safety in this patient group.
We distributed an online survey, in seven European languages, via professional networks and social media. The survey explored a range of medication safety strategies and whether they were in use (and if so, whether fully or partially implemented) or being planned. Demographic information about respondents and their ICUs was also captured. A descriptive analysis was conducted, which included exploring geographical variation.
We obtained 587 valid responses from 32 different countries, with 317 (54%) completed by pharmacy staff. Medication safety practices most commonly implemented were patients' allergies being visible for all staff involved in their care (fully implemented in 382 (65%) of respondents' ICUs), standardised emergency medication stored in a fixed place (337, 57%), and use of standardised medication concentrations for commonly used intravenous infusions (330, 56%). Electronic prescribing systems were fully implemented in 310 (53%). A pharmacist was reported to be fully implemented in 181 (31%) of ICUs, of which there was 126 (70%) where there was a pharmacist review of all ordered medication five days per week. Critical care pharmacists were most common in Northern European ICUs (fully implemented to ICUs in 102, 50%) and electronic prescribing in Western Europe (108, 65%).
There is considerable variation in medication safety strategies used within European ICUs, both between and within geographical areas. Our findings may be helpful to ICU staff in identifying strategies that should be considered for implementation.
与入住普通病房的患者相比，重症监护病房（ICU）的患者可能更容易出现用药错误。然而，对于欧洲ICU所采用的用药安全策略知之甚少。我们的目的是探讨欧洲ICU正在使用和计划采用的策略，确定存在差异的领域，并为改善该患者群体的用药安全提供建议。
我们通过专业网络和社交媒体以七种欧洲语言分发了一份在线调查问卷。该调查探讨了一系列用药安全策略，以及这些策略是否正在使用（如果是，是全面实施还是部分实施）或正在计划采用。还收集了受访者及其所在ICU的人口统计学信息。进行了描述性分析，包括探讨地域差异。
我们从32个不同国家获得了587份有效回复，其中317份（54%）由药房工作人员完成。最常实施的用药安全措施包括让所有参与患者护理的工作人员都能看到患者的过敏情况（382个受访者所在ICU，65%全面实施）、将标准化急救药物存放在固定位置（337个，57%）以及对常用静脉输液使用标准化药物浓度（330个，56%）。电子处方系统在310个（53%）中全面实施。据报告，181个（31%）ICU配备了药剂师，其中126个（70%）每周有五天药剂师会对所有医嘱用药进行审核。重症监护药剂师在北欧的ICU中最为常见（102个，50%全面实施），电子处方在西欧最为常见（108个，65%）。
欧洲ICU所采用的用药安全策略在不同地理区域之间以及区域内部都存在很大差异。我们的研究结果可能有助于ICU工作人员确定应考虑实施的策略。
