儿科住院患者的药物错误和不良药物事件
R Kaushal1, D W Bates, C Landrigan
1Children's Hospital, Enders 609, Longwood Avenue, Boston, MA 02115, USA.
JAMA
|May 10, 2001
概括
药物错误在儿科医院环境中很常见,与成年人相比,潜在不良药物事件 (ADEs) 的发生率很高. 大多数错误发生在药物订购过程中,这凸显了改善预防策略的必要性.
科学领域:
- 儿科药理学 儿科药理学
- 患者安全研究的研究.
- 阳性损伤的流行病学
背景情况:
- 包括药物错误在内的阳性创伤在住院患者中构成了重大挑战.
- 有限的流行病学数据存在于药物错误,特别是在儿科住院病人的设置.
研究的目的:
- 为了确定药物错误的发生率,药物不良事件 (ADEs) 和儿科住院患者的潜在ADEs.
- 为了比较儿科的ADE比率与以前记录的成人比率.
- 确定常见的药物错误类型,并评估预防策略的潜在有效性.
主要方法:
- 一项前性队列研究,涉及两个学术机构的1120名患者,持续了六周.
- 数据收集包括临床工作人员报告,药物订购表,药物管理记录和患者病历.
- 通过严格的审查过程进行了药物错误,潜在的ADE和ADE的识别.
主要成果:
- 从10,778个药物订单中,共发现了616个药物错误 (5.7%),115个潜在的不良事件 (1.1%) 和26个不良事件 (0.24%).
- 儿科患者潜在的ADE的发生率是成年人的三倍,特别是在新生儿重症监护病房.
- 大多数潜在的ADE源于药物订购阶段,涉及错误的剂量,抗感染药物和静脉注射药物.
结论:
- 在儿科住院环境中,药物错误很普遍.
- 潜在的ADEs的高率强调了迫切需要加强安全措施和干预措施的必要性.
- 计算机化医生订单输入和病房药剂师在预防ADE方面显示出显著的潜力.
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