Anderson J G, Jay S J, Anderson M, Hunt T J
Department of Sociology & Anthropology, Purdue University, West Lafayette, IN 47907, USA.
Proc AMIA Annu Fall Symp. 1997:228-32.
In this study a dynamic computer simulation model is used to estimate the effectiveness of various information systems applications designed to detect and prevent medication errors that result in adverse drug events (ADEs). The model simulates the four stages of the drug ordering and delivery system: prescribing, transcribing, dispensing and administering drugs. In this study we simulated interventions that have been demonstrated in prior studies to decrease error rates. The results demonstrated that a computerized information system that detected 26% of medication errors and prevented associated ADEs could save 1,226 days of excess hospitalization and $1.4 million in hospital costs annually. Those results suggest that such systems are potentially a cost-effective means of preventing ADEs in hospitals. The results demonstrated the importance of viewing adverse drug events from a systems perspective. Prevention efforts that focus on a single stage of the process had limited impact on the overall error rate. This study suggests that system-wide changes to the drug-ordering and delivery system are required to significantly reduce adverse drug events in a hospital setting.
在本研究中,使用了一个动态计算机模拟模型来评估各种旨在检测和预防导致药物不良事件(ADE)的用药错误的信息系统应用程序的有效性。该模型模拟了药物订购和发放系统的四个阶段:开处方、转录、配药和给药。在本研究中,我们模拟了先前研究中已证明可降低错误率的干预措施。结果表明,一个能检测出26%的用药错误并预防相关药物不良事件的计算机化信息系统,每年可节省1226天的额外住院时间和140万美元的医院成本。这些结果表明,此类系统可能是预防医院中药物不良事件的一种具有成本效益的手段。结果证明了从系统角度看待药物不良事件的重要性。专注于该过程单个阶段的预防措施对总体错误率的影响有限。本研究表明,需要对医院的药物订购和发放系统进行全系统的变革,以显著减少医院环境中的药物不良事件。