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评估智能输液泵互操作性对减少用药错误的影响:一项系统文献综述

Evaluating the Impact of Smart Infusion Pump Interoperability on Reducing Medication Administration Errors: A Systematic Literature Review.

作者信息

Borrelli Eric P, Lucaci Julia D, Wilson Nicole S, Taneja Ashley, Weiss Mia, Beer Idal

机构信息

Health Economics and Outcomes Research, MMS, Becton, Dickinson and Company, San Diego, CA, USA.

HEOR Strategic Planning; Becton, Dickinson and Company, Franklin Lakes, NJ, USA.

出版信息

Med Devices (Auckl). 2025 Apr 15;18:247-260. doi: 10.2147/MDER.S522534. eCollection 2025.

Abstract

PURPOSE

Medication administration errors remain a persistent issue in the US healthcare system, impacting patient safety and leading to worsened outcomes, including increased mortality. Smart infusion pump interoperability with electronic health records (EHRs) has the potential to reduce intravenous (IV) medication administration errors. Smart Infusion pumps safely deliver IV medications using drug libraries that set standard dosing limits. Interoperability is their ability to wirelessly connect to EHRs to receive medications orders directly minimizing error-prone manual programming steps. However, despite being implemented over a decade ago, its real-world impact remains largely underexplored.

METHODS AND MATERIALS

A systematic literature review (SLR) of PubMed/Medline and Embase in November 2024 identified peer-reviewed studies assessing medication administration errors pre- and post- interoperability implementation in the inpatient hospital setting. The primary outcome measured error types directly impacted by interoperability. The secondary outcome assessed the cumulative reduction in medication administration errors.

RESULTS

Three studies met the inclusion criteria, spanning general community hospitals, pediatric facilities, and intensive care units (ICUs). For the primary outcome of assessing medication administration errors impactable by interoperability, interoperability implementation resulted in a 15.4% to 54.8% reduction in specific medication administration errors. For the secondary outcome of all medication administration errors, the cumulative reductions in medication administration errors post-implementation ranged from 21.2% to 90.5%, with variability influenced by baseline compliance, study setting, and patient populations.

CONCLUSION

Smart infusion pump interoperability demonstrated consistent potential to enhance medication safety by addressing key error types and reducing cumulative errors in real-world settings. However, future research is needed to assess its impact on adverse drug events, clinician workflows, and patient outcomes. These findings underscore the importance of tailored implementation strategies to maximize interoperability's effectiveness in improving patient safety.

摘要

目的

在美国医疗系统中,用药错误仍是一个长期存在的问题,影响患者安全并导致包括死亡率上升在内的不良后果恶化。智能输液泵与电子健康记录(EHR)的互操作性有潜力减少静脉(IV)用药错误。智能输液泵利用设定标准剂量限制的药物库安全地输送静脉药物。互操作性是指它们能够无线连接到EHR,直接接收用药医嘱,最大限度地减少容易出错的手动编程步骤。然而,尽管该技术已实施了十多年,但其在现实世界中的影响仍在很大程度上未得到充分探索。

方法和材料

2024年11月对PubMed/Medline和Embase进行的系统文献综述(SLR)确定了评估住院医院环境中互操作性实施前后用药错误的同行评审研究。主要结果衡量直接受互操作性影响的错误类型。次要结果评估用药错误的累计减少情况。

结果

三项研究符合纳入标准,涵盖综合社区医院、儿科设施和重症监护病房(ICU)。对于评估可受互操作性影响的用药错误这一主要结果,互操作性实施使特定用药错误减少了15.4%至54.8%。对于所有用药错误的次要结果,实施后用药错误的累计减少幅度为21.2%至90.5%,其差异受基线依从性、研究环境和患者群体的影响。

结论

智能输液泵互操作性通过解决关键错误类型并减少现实环境中的累计错误,展现出增强用药安全性的持续潜力。然而,需要未来的研究来评估其对药物不良事件、临床工作流程和患者结局的影响。这些发现强调了量身定制实施策略对于最大化互操作性在改善患者安全方面有效性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0570/12009041/f821e33e1193/MDER-18-247-g0001.jpg

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