识别与高风险阿片类药物管理相关的不良事件,使用紧急部门触发工具
Richard T Griffey1,2, Neha Bollam3, Ryan M Schneider1
1Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
概括
ED触发器工具 (EDTT) 在ED中检测到与阿片类药物相关的不良事件 (AE) 在26%的高风险管理中. 使用特定阿片类药物触发剂的这种监测策略有效地识别了患者安全风险.
科学领域:
- 紧急医疗 紧急医疗
- 患者安全 患者安全
- 药物监督 药物监督 药物监督
背景情况:
- 已知ED解药后的阿片类药物相关不良事件 (AE),但ED停留期间的AE不太了解.
- 在ED中检测阿片类副作用是具有挑战性的,因为频繁的管理和非特异性的监测.
- 紧急部门触发工具 (EDTT) 被评估用于检测ED内高风险阿片类药物使用的AE.
研究的目的:
- 评估ED触发器工具 (EDTT) 在紧急部门 (ED) 访问期间识别阿片类药物相关不良事件 (AE) 的实用性.
- 评估与高风险阿片类药物管理相关的特定触发因素,以检测AE.
主要方法:
- 使用EDTT进行的多中心回顾性研究的二次分析.
- 分析了两个触发因素:M2 (≥3剂量水利摩尔) 和M18 (阿片类药物 + 二二类药物).
- 在18个月内,EDTT应用于每个站点的约3000条记录,采用两级审查流程.
主要成果:
- 3.0%的访问涉及高风险阿片类药物管理触发器 (M2,M18,或两者).
- 在具有触发因素的审查记录中,5.3%至少有一个触发因素.
- 与阿片类药物相关的副作用在26.2%的触发性访问中被发现,M2 (47.4%) 的比率高于M18 (21.9%).
结论:
- 大约5%的ED访问涉及高风险阿片类药物管理,其中26%的结果是AE.
- 在AE检测方面,EDTT被证明是有效的,在各个地点都有一致的率.
- 聚焦于高风险阿片类药物管理的触发器显示出作为改善患者安全的监控策略的希望.
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