Rajakumar Sutha, Rajah Retha, Thanimalai Subramaniam, Mokhtar Fadzlin Binti Mohd, Ramachandram Dinesh Sangarran
Department of Pharmacy, Hospital Seberang Jaya, Jln Tun Hussein Onn, Seberang Jaya, Pulau Pinang, Malaysia.
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia.
J Eval Clin Pract. 2025 Jun;31(4):e70167. doi: 10.1111/jep.70167.
Administering intravenous (IV) drugs carries a high risk of adverse effects due to their direct entry into circulation. Identifying the prevalence and types of IV administration errors and the drugs involved is crucial for implementing effective interventions to reduce such errors.
This systematic review aimed to examine and synthesise the available articles on medication errors involving IV administration in hospitalised patients.
A comprehensive search was conducted using electronic databases, including PubMed, Ovid Medline, and CINAHL. The search was performed without time limitation up to July 2023. However, only articles published in English and human subjects were included. The quality of the studies was appraised using the Newcastle-Ottawa quality assessment scale (NOS). This systematic review was registered with PROSPERO (CRD42023469352).
Database searches yielded 2177 articles; after duplicate removal, 1717 underwent title and abstract screening, and 23 were included after full-text review. The studies were from 12 countries, and the multicentre study included countries from Europe, Africa, the Americas, Asia, and Australia. The majority of the studies were conducted in either teaching hospitals (n = 11) or university-affiliated hospitals (n = 7), with most involving direct observation (n = 21). IV administration errors exhibit a broad prevalence range of 5.0%-62.9%, involving various types such as wrong diluent, dose, route, rate, technique, omission, and timing. Studies lack uniformity in reporting, with some not specifying prevalence. The highest prevalence of specific errors varies across settings.
Our review highlights that IV medication error rates vary based on study design, setting, and population. Standardised definitions, reporting procedures, and reliable tracking methods are needed. Human factors, system issues, and environmental stressors influence medication errors. Future research must improve our understanding and address these factors to enhance patient safety and healthcare quality.
静脉注射药物因其直接进入循环系统而具有较高的不良反应风险。识别静脉给药错误的发生率、类型以及所涉及的药物对于实施有效的干预措施以减少此类错误至关重要。
本系统评价旨在审查和综合有关住院患者静脉给药用药错误的现有文章。
使用电子数据库进行全面检索，包括PubMed、Ovid Medline和CINAHL。检索截至2023年7月，无时间限制。然而，仅纳入英文发表的文章和以人为研究对象的文章。使用纽卡斯尔-渥太华质量评估量表（NOS）对研究质量进行评估。本系统评价已在PROSPERO（CRD42023469352）注册。
数据库检索产生了2177篇文章；去除重复项后，1717篇进行了标题和摘要筛选，23篇在全文审查后被纳入。这些研究来自12个国家，多中心研究包括来自欧洲、非洲、美洲、亚洲和澳大利亚的国家。大多数研究在教学医院（n = 11）或大学附属医院（n = 7）进行，大多数涉及直接观察（n = 21）。静脉给药错误的发生率范围广泛，为5.0% - 62.9%，涉及多种类型，如错误的稀释剂、剂量、途径、速率、技术、遗漏和时间安排。研究报告缺乏一致性，一些未明确说明发生率。特定错误的最高发生率因环境而异。
我们的综述强调，静脉用药错误率因研究设计、环境和人群而异。需要标准化的定义、报告程序和可靠的跟踪方法。人为因素、系统问题和环境压力源会影响用药错误。未来的研究必须增进我们对这些因素的理解并加以解决，以提高患者安全和医疗质量。
