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小児の入院患者における薬物誤用および薬物の有害事象
R Kaushal1, D W Bates, C Landrigan
1Children's Hospital, Enders 609, Longwood Avenue, Boston, MA 02115, USA.
JAMA
|May 10, 2001
まとめ
小児病院の設定では,薬剤の誤用が一般的であり,成人と比べて潜在的な有害薬剤イベント (ADEs) の割合が高くなります. ほとんどのエラーは,薬物の注文中に発生し,改善された予防戦略の必要性を強調しました.
科学分野:
- 小児薬理学 小児薬理学
- 患者の安全性に関する研究
- イアトロゲン性損傷の流行病学
背景:
- 投薬誤りを含むイアトロゲン性損傷は,入院患者にとって大きな課題となっています.
- 特に小児の入院医療における薬物誤用に関する疫学的なデータは限られている.
研究 の 目的:
- 小児の入院患者における薬物誤用,薬物有害事象 (ADEs),および潜在的なADEsの発生率を決定する.
- 小児のADE率を,以前に記録された成人のADE率と比較する.
- 薬剤の誤用の一般的なタイプを特定し,予防戦略の潜在的な有効性を評価する.
主な方法:
- 2つの学術機関で6週間にわたって1,120人の患者を対象とした前向きなコホート研究.
- データ収集には,臨床スタッフの報告,薬の注文シート,投与記録,患者チャートが含まれていました.
- 薬剤の誤り,潜在的なADE,およびADEの特定は,厳格なレビュープロセスを通じて行われました.
主要な成果:
- 10,778件の医薬品注文から,合計616件の医薬品エラー (5.7%),115件の潜在的な有害事象 (1.1%),および26件の有害事象 (0.24%) が確認されました.
- 小児患者の潜在的なADEの割合は,特に新生児重症病棟では,成人の3倍以上でした.
- ほとんどの潜在的なADEは,誤った投与量,抗感染薬,静脈注射薬を含む薬物注文段階から生じた.
結論:
- 小児の入院環境では,薬剤の誤用が一般的です.
- 潜在的なADEsの高い割合は,強化された安全対策と介入の緊急の必要性を強調しています.
- コンピューター化された医師の注文入力と病棟ベースの薬剤師は,ADEを予防する重要な可能性を示しています.
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