评估药学学生在电子记录中输入药物历史数据的准确性
Truc Ngoc Thi Bui1, Michael Ward2, Andrew Vanlint3
1University of South Australia, SA Pharmacy, Central Adelaide Local Health Network, SA Health.
药房学生在电子医疗记录 (EMR) 中记录药物历史是安全的,大多数错误不会造成任何或轻微伤害. 这项研究支持整合EMR访问学生学习和患者护理贡献.
科学领域:
- 药房 教育 教育 药房 教育
- 临床信息学 临床信息学
- 患者安全 患者安全
背景情况:
- 药学学生在临床实习期间为药物历史做出贡献.
- 电子医疗记录 (EMR) 在药学学生教育中未得到充分利用.
- 目前对EMR访问的限制限制了南澳大利亚的学生捐款.
研究的目的:
- 评估药学学生的安全性,将药物历史记录直接记录在EMR中.
- 为有关学生EMR访问和监督的政策提供信息.
主要方法:
- 在11个医院进行了36周的前性研究.
- 药房学生将药物数据输入EMR.
- 监督药剂师审查了记录中的差异,并评估了潜在的危害.
主要成果:
- 在2262种药物中发现了145种差异.
- 最常见的错误:错误的指示 (44.8%) 和遗漏 (19.3%).
- 大多数差异导致"没有伤害" (56.6%) 或"轻微伤害" (31.7%);一个"严重伤害"的例子.
结论:
- 在EMR中学生的药物历史记录的文档是安全的.
- 这些发现支持为学生EMR访问开发工作流程.
- 关于监督模型的建议,以加强患者的护理和教育.
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