関連する実験動画
Updated: Jul 6, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
コンピュータ化された医師の注文入力システムの役割は,薬の誤差を容易にすることにある
Ross Koppel1, Joshua P Metlay, Abigail Cohen
1Department of Sociology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19104 USA. rkoppel@sas.upenn.edu
JAMA
|March 10, 2005
まとめ
コンピューター化された医師の注文入力 (CPOE) システムは,新しい薬のエラーリスクを導入することができます. この研究では,CPOEによって促進される22種類のエラーが発見され,その多くは毎週発生しています.
科学分野:
- 医療情報工学 医療情報工学
- 患者の安全性について
- クリニック薬局 臨床薬局
背景:
- 病院のコンピュータ化された医師の注文入力 (CPOE) システムは,予防可能な害の主要な源である薬剤の誤差を減らすことを目的としています.
- 報告されたエラー削減率にもかかわらず,CPOEが新しいエラータイプを導入する可能性があることは,まだ十分に研究されていません.
研究 の 目的:
- 処方エラーのリスクを緩和するCPOEの役割を特定し,定量化します.
- CPOEシステムが不意に薬剤の誤りにつながり得る方法を調査する.
主な方法:
- 質的 (インタビュー,フォーカスグループ,観察) と定量的 (アンケート) のアプローチを組み合わせた混合方法の研究.
- 2年間にわたり,高等保健教科病院の住居スタッフ,医師,看護師,病院のリーダーを対象にしました.
- 現実世界の使用と潜在的な問題を捉えるために,CPOEシステムとのハウススタッフの相互作用に焦点を当てました.
主要な成果:
- CPOEシステムによって促進される22の異なるタイプの医薬品エラーリスクを特定しました.
- 共通するエラーには,断片化された表示,薬局データの誤った解釈,無視された警告,二重投与につながる機能的分離,および柔軟性のない注文形式が含まれています.
- 家のスタッフの75%以上が,これらのエラーリスクを毎週またはより頻繁に観察していると報告しています.
結論:
- 主要なCPOEシステムは,意図された目的とは対照的に,しばしば薬剤の誤差リスクを容易にする可能性があります.
- 臨床医や医療機関は,予防するエラーに加えて,CPOEによって引き起こされるエラーにも積極的に対処しなければなりません.
- システムの設計と実装は,新たに導入された患者の安全上の危険を軽減するために注意深く注意する必要があります.
関連する概念動画
01:25Errors occurring during blood pressure monitoring
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
01:10Documentation of Nursing Diagnosis
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters assessment...
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:13Parameters Affecting Nonlinear Elimination: Zero-Order Input, First-Order Absorption and Two-Compartment Model
Drugs administered through various routes can lead to nonlinear elimination, resulting in complex pharmacokinetic behaviors crucial to understanding efficacious drug dosing.
When a drug is administered through a constant intravenous infusion and eliminated via nonlinear pharmacokinetics, it follows zero-order input. For example, oral drugs undergo first-order absorption upon administration and are eliminated through nonlinear pharmacokinetics.
In the case of subcutaneously administered drugs,...
When a drug is administered through a constant intravenous infusion and eliminated via nonlinear pharmacokinetics, it follows zero-order input. For example, oral drugs undergo first-order absorption upon administration and are eliminated through nonlinear pharmacokinetics.
In the case of subcutaneously administered drugs,...
01:28Dosage Regimens: Designs and Approaches
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
01:26Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...