Intercepting Medication Errors in Pediatric In-patients Using a Prescription Pre-audit Intelligent Decision System: A Single-center Study,Pediatric Drugs

当前位置： X-MOL 学术 › Pediatric Drugs › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Intercepting Medication Errors in Pediatric In-patients Using a Prescription Pre-audit Intelligent Decision System: A Single-center Study
Pediatric Drugs ( IF 3.4 ) Pub Date : 2022-07-30 , DOI: 10.1007/s40272-022-00521-2
Guangfei Wang ₁ , Feng Zheng ₁ , Guiyao Zhang ₂ , Yidie Huang ₁ , Qiaofeng Ye ₁ , Xunjie Zhang ₁ , Xuyuan Li ₃ , Ying Xu ₁ , Xuhui Zhang ₁ , Xiaobo Zhang ₄ , Zhiping Li ₁

Affiliation

Objectives

Medication errors can happen at any phase of the medication process at health care settings. The objective of this study is to identify the characteristics of severe prescribing errors at a pediatric hospital in the inpatient setting and to provide recommendations to improve medication safety and rational drug use.

Methods

This descriptive retrospective study was conducted at a tertiary pediatric hospital using data collected from Jan. 1st, 2019 to Dec. 31st, 2020. During this period, the Prescription Pre-audit Intelligent Decision System was implemented. Medication orders with potential severe errors would trigger a Level 7 alert and would be intercepted before it reached the pharmacy. Trained pharmacists maintained the system and facilitated decision making when necessary. For each order intercepted by the system the following patient details were recorded and analyzed: patient age, patient’s department, drug classification, dosage forms, route of administration, and the type of error.

Results

A total of 2176 Level 7 medication orders were intercepted. The most common errors were associated with drug dosage, administration route, and dose frequency, accounting for 35.2%, 32.8% and 13.2%, respectively. Of all the intercepted oerrors. 53.6% occurred in infants aged < 1 year. Administration routes involved were mainly intravenous, oral and external use drugs. Most alerts came from the neonatology department and constituted 40.5% of the total alerts, followed by the nephrology department 15.9% and pediatric intensive care unit (PICU) 11.3%. As to dosage forms, injections accounted for 50.4% of alerts, with 21.3% attributable to topical solutions, 9.1% to tablets, and 5.7% to inhalation. Anti-infective agents were the most common therapeutic drugs prescribed with errors.

Conclusions

The Prescription Pre-audit Intelligent Decision System, with the supervision of trained pharmacists can validate prescriptions, increase prescription accuracy, and improve drug safety for hospitalized children. It is a medical service model worthy of consideration.

中文翻译：

使用处方预审智能决策系统拦截儿科住院患者用药错误：一项单中心研究

目标

医疗机构用药过程的任何阶段都可能发生用药错误。本研究的目的是确定儿科医院住院环境中严重处方错误的特征，并为提高用药安全性和合理用药提供建议。

方法

这项描述性回顾性研究是在一家三级儿科医院使用2019年1月1日至2020年12月31日收集的数据进行的。在此期间，实施了处方预审智能决策系统。有潜在严重错误的药物订单将触发 7 级警报，并在到达药房之前被拦截。训练有素的药剂师维护系统并在必要时促进决策。对于系统截获的每个订单，记录和分析以下患者详细信息：患者年龄、患者科室、药物分类、剂型、给药途径和错误类型。

结果

共截获 2176 份 7 级药物订单。最常见的错误与药物剂量、给药途径和给药频率有关，分别占35.2%、32.8%和13.2%。在所有拦截的错误中。53.6% 发生在 1 岁以下的婴儿中。涉及的给药途径主要是静脉内、口服和外用药物。大多数警报来自新生儿科，占警报总数的 40.5%，其次是肾脏科，占 15.9%，儿科重症监护室 (PICU) 占 11.3%。剂型方面，注射剂占50.4%，局部用药占21.3%，片剂占9.1%，吸入占5.7%。抗感染药物是最常见的有错误处方的治疗药物。