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病房药师和卫星药房药师在改善医院药学服务中的关键作用

The Critical Role of Ward-Based and Satellite Pharmacists in Improving Pharmaceutical Care in Hospital.

作者信息

Afra Fatemeh, Abedi Fatemeh Amou, Feizabadi Faezeh, Mahboobipour Amir Ali, Rastegarpanah Mansoor

机构信息

Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Department of Pharmaceutical Care, Nikan General Hospital, Tehran, Iran.

出版信息

J Res Pharm Pract. 2024 Sep 26;13(1):19-26. doi: 10.4103/jrpp.jrpp_28_24. eCollection 2024 Jan-Mar.

Abstract

OBJECTIVE

Medical errors are the third leading cause of death in the U. S., with medication mistakes being a common issue. Medication reconciliation (MR) involves comparing patients' orders with their existing medications to prevent errors. Pharmacists are ideally suited for MR tasks. Effective MR can reduce drug-related rehospitalizations. This study aimed to investigate medication errors among hospitalized patients and to evaluate the impact of ward-based and satellite pharmacists on the quality of drug administration services.

METHODS

A descriptive cross-sectional study was conducted at Nikan General Hospitals in Tehran, Iran, over 6 months. We assessed the performance of ward-based and satellite pharmacists in various wards. All patient medication activities were meticulously monitored and recorded. Adjusted drug-related problem (DRP) codes were then used to identify medication errors and the corresponding interventions.

FINDINGS

The study included 1682 patients, each experiencing at least one DRP. The data revealed a DRP prevalence of 6.44% (95% confidence interval: 6.15%-6.75%). A total of 2173 DRPs were identified, with 650 originating from intensive care units and the remaining 1523 from other wards. Notably, DRPs attributed to nurses (labeled as S2) constituted 18.36%, and those due to drug interactions (classified as D7) accounted for 13.48%. Following intervention, the most common pharmacist recommendations were initiating a medication (14.04%), discontinuing a medication (13.12%), changing a medication (11.38%), and reducing doses (11.09%).

CONCLUSION

Effective MR, supported by comprehensive training of medical staff such as physicians and nurses, can significantly reduce DRPs in hospitalized patients. Clinical pharmacists play a vital role in this context.

摘要

目的

医疗差错是美国第三大死因,用药错误是一个常见问题。用药核对(MR)包括将患者的医嘱与其现有用药进行比对以预防差错。药剂师非常适合从事用药核对任务。有效的用药核对可减少与药物相关的再次住院情况。本研究旨在调查住院患者中的用药差错,并评估病房药师和卫星药房药师对给药服务质量的影响。

方法

在伊朗德黑兰的尼坎综合医院进行了一项为期6个月的描述性横断面研究。我们评估了病房药师和卫星药房药师在各个病房的工作表现。对所有患者的用药活动进行了细致监测和记录。然后使用调整后的药物相关问题(DRP)编码来识别用药差错及相应的干预措施。

结果

该研究纳入了1682名患者,每名患者至少出现一个药物相关问题。数据显示药物相关问题的患病率为6.44%(95%置信区间:6.15% - 6.75%)。共识别出2173个药物相关问题,其中650个源自重症监护病房,其余1523个来自其他病房。值得注意的是,归因于护士的药物相关问题(标记为S2)占18.36%,因药物相互作用导致的问题(归类为D7)占13.48%。干预后,药剂师最常见的建议是开始用药(14.04%)、停用药物(13.12%)、更换药物(11.38%)和减少剂量(11.09%)。

结论

在医生和护士等医务人员的全面培训支持下,有效的用药核对可显著减少住院患者的药物相关问题。在此背景下,临床药师发挥着至关重要的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4abd/11524570/8ac61fab5bab/JRPP-13-19-g001.jpg

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