减少儿童神经病室住院病人的出院药物调和错误
Sara Adducchio1, Ethan D Grant1, Laura D Fonseca1
1Department of Neurology (SA, LDF, GK), Dayton Children's Hospital; Department of Pediatrics (EDG, GK), Wright State University Boonshoft School of Medicine, Dayton; and Department of Nephrology (AO), Dayton Children's Hospital, OH.
Neurology. Clinical practice
|March 25, 2024
概括
在儿科患者中减少出院药物调和错误是可以实现的. 专门的神经病学护士和标准化的电子订单显著减少了错误,改善了患者的安全,而没有增加医院费用.
科学领域:
- 儿科神经学 儿科神经学
- 改善健康质量 改善健康质量
- 药物安全 药物安全
背景情况:
- 放出药物调和 (DMR) 错误在儿科中很普遍,比率从26%到42.2%.
- 这些错误带来了重大风险,特别是在儿科患者的护理过渡期间.
- 启动了一项质量改进项目,以解决代顿儿童医院的高DMR错误率.
研究的目的:
- 为了降低儿科患者的出院药物调和错误率.
- 实施和评估有针对性的干预措施,以提高出院时的药物准确性.
- 具体来说,在患者中减少与发作救助药物相关的错误.
主要方法:
- 在19个月的时间里 (2021年9月至2023年2月) 使用Plan-Do-Study-Act周期实施了两个干预措施.
- 干预措施1:雇佣神经病学专业护士作为书记,使用标准化的出院护理计划模板.
- 干预措施2:通过电子医疗记录订单面板,通过标准化的抢救药物订单.
主要成果:
- 基线的DMR错误率为15.7% (7个错误/月).
- 在干预1之后,错误率降至5.3% (每月2个错误).
- 在干预措施2之后,该率进一步下降至2.9% (1个错误/月),随后的10周期间为0%的错误.
结论:
- 实现了持续减少儿科DMR错误,特别是在患者中.
- 利用专门的神经病学护士和电子订单面板有效地提高了释放药物的准确性.
- 这些干预措施提高了患者的安全性,而不会增加医院费用.
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