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Medication discrepancies in transition of care of hospitalised children in Brazil: a multicentric study
Archives of Disease in Childhood ( IF 4.3 ) Pub Date : 2021-10-01 , DOI: 10.1136/archdischild-2020-320225
Giulyane Targino Aires-Moreno 1 , Thaciana Dos Santos Alcântara 1 , Dyego Carlos Souza Anacleto de Araújo 1 , Simony da Mota Soares 2 , Vanessa Terezinha Gubert 3 , Vanessa Marcon de Oliveira 3 , Cristiane Munaretto Ferreira 3 , Erica Freire Vasconcelos-Pereira 3 , Ana Rafaela Pires Lira 4 , Clarice Chemello 4 , Layse Maria Soares de Oliveira 5 , Alfredo Dias de Oliveira-Filho 5 , Divaldo Lyra 6
Affiliation  

Objective To determine the incidence of medication discrepancies in transition points of care of hospitalised children. Design A prospective observational multicentre study was carried out between February and August 2019. Data collection consisted of the following steps: sociodemographic data collection, clinical interview with the patient’s caregiver, review of patient prescriptions and evaluation of medical records. Medication discrepancies were classified as intentional (documented or undocumented) and unintentional. In addition, discrepancies identified were categorised according to the medication discrepancy taxonomy. Unintentional discrepancies were assessed for potential clinical harm to the patient. Setting Paediatric clinics of four teaching hospitals in Brazil. Patients Children aged 1 month–12 years. Findings A total of 248 children were included, 77.0% (n=191) patients had at least one intentional discrepancy; 20.2% (n=50) patients had at least one unintended discrepancy and 15.3% (n=38) patients had at least one intentional discrepancy and an unintentional one. The reason for the intentional discrepancy was not documented in 49.6% (n=476) of the cases. The most frequent unintentional discrepancy was medication omission (54.1%; n=66). Low potential to cause discomfort was found in 53 (43.4%) unintentional discrepancies, while 55 (45.1%) had the potential to cause moderate discomfort and 14 (11.5%) could potentially cause severe discomfort. Conclusions Although most medication discrepancies were intentional, the majority of these were not documented by the healthcare professionals. Unintentional discrepancies were often related to medication omission and had a potential risk of causing harm to hospitalised children. All data relevant to the study are included in the article or uploaded as supplemental information: lepfs.ufs@gmail.com.

中文翻译:

巴西住院儿童护理过渡中的药物差异:一项多中心研究

目的确定住院儿童护理过渡点用药差异的发生率。设计 在 2019 年 2 月至 8 月期间进行了一项前瞻性观察性多中心研究。数据收集包括以下步骤:社会人口学数据收集、与患者护理人员的临床访谈、患者处方审查和医疗记录评估。药物差异被分类为有意的(记录在案的或未记录在案的)和无意的。此外,根据药物差异分类法对确定的差异进行分类。对无意的差异进行了评估,以确定对患者的潜在临床危害。在巴西设置四家教学医院的儿科诊所。患者 1 个月至 12 岁的儿童。结果 共纳入 248 名儿童,77.0% (n=191) 患者至少有一个故意差异;20.2% (n=50) 的患者至少有一个无意的差异,15.3% (n=38) 的患者至少有一个有意的差异和一个无意的差异。49.6% (n=476) 的案例中没有记录故意差异的原因。最常见的无意差异是药物遗漏(54.1%;n=66)。在 53 个 (43.4%) 无意差异中发现引起不适的可能性较低,而 55 个 (45.1%) 有可能引起中度不适,14 个 (11.5%) 可能引起严重不适。结论 尽管大多数药物差异是故意的,但其中大部分都没有被医疗保健专业人员记录下来。无意的差异通常与药物遗漏有关,并有对住院儿童造成伤害的潜在风险。与研究相关的所有数据都包含在文章中或作为补充信息上传:lepfs.ufs@gmail.com。
更新日期:2021-09-17
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