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危重患者处方用药错误失误分析
Author(s) -
Suclupe Stefanie,
MartinezZapata Maria Jose,
Mancebo Jordi,
FontVaquer Assumpta,
CastilloMasa Ana María,
Viñolas Iris,
Morán Indalecio,
Robleda Gemma
Publication year - 2020
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14322
Subject(s) - medicine , medical prescription , intensive care unit , workload , observational study , emergency medicine , morning , patient safety , health care , nursing , computer science , economics , economic growth , operating system
Aim To determine the prevalence and magnitude of medication errors and their association with patients' sociodemographic and clinical characteristics and nurses' work conditions. Design An observational, analytical, cross‐sectional and ambispective study was conducted in critically ill adult patients. Methods Data concerning prescription errors were collected retrospectively from medical records and administration errors were identified through direct observation of nurses during drug administration. Those data were collected between April and July 2015. Results A total of 650 prescription errors were identified for 961 drugs in 90 patients (mean error 7[ SD 4.1] per patient) and prevalence of 47.1% (95% CI 44–50). The most frequent error was omission of the prescribed medication. Intensive care unit stay was a risk factor associated with omission error (OR 2.14; 1.46–3.14: p  < .01). A total of 294 administration errors were identified for 249 drugs in 52 patients (mean error 6 [ SD 6.7] per patient) and prevalence of 73.5% (95% CI 68–79). The most frequent error was interruption during drug administration. Admission to the intensive care unit (OR 0.37; 0.21–0.66: p  < .01), nurses’ morning shift (OR 2.15; 1.10–4.18: p  = .02) and workload perception (OR 3.64; 2.09–6.35: p  < .01) were risk factors associated with interruption. Conclusions Medication errors in prescription and administration were frequent. Timely detection of errors and promotion of a medication safety culture are necessary to reduce them and ensure the quality of care in critically ill patients. Impact Medication errors occur frequently in the intensive care unit but are not always identified. Due to the vulnerability of seriously ill patients and the specialized care they require, an error can result in serious adverse events. The study shows that medication errors in prescription and administration are recurrent but preventable. These findings contribute to promote awareness in the proper use of medications and guarantee the quality of nursing care.

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