The Reduction in Medical Errors on Implementing an Intensive Care Information System in a Setting Where a Hospital Electronic Medical Record System is Already in Use: Retrospective Analysis.
{"title":"The Reduction in Medical Errors on Implementing an Intensive Care Information System in a Setting Where a Hospital Electronic Medical Record System is Already in Use: Retrospective Analysis.","authors":"Yusuke Seino, Nobuo Sato, Masafumi Idei, Takeshi Nomura","doi":"10.2196/39782","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although the various advantages of clinical information systems in intensive care units (ICUs), such as intensive care information systems (ICISs), have been reported, their role in preventing medical errors remains unclear.</p><p><strong>Objective: </strong>This study aimed to investigate the changes in the incidence and type of errors in the ICU before and after ICIS implementation in a setting where a hospital electronic medical record system is already in use.</p><p><strong>Methods: </strong>An ICIS was introduced to the general ICU of a university hospital. After a step-by-step implementation lasting 3 months, the ICIS was used for all patients starting from April 2019. We performed a retrospective analysis of the errors in the ICU during the 6-month period before and after ICIS implementation by using data from an incident reporting system, and the number, incidence rate, type, and patient outcome level of errors were determined.</p><p><strong>Results: </strong>From April 2018 to September 2018, 755 patients were admitted to the ICU, and 719 patients were admitted from April 2019 to September 2019. The number of errors was 153 in the 2018 study period and 71 in the 2019 study period. The error incidence rates in 2018 and 2019 were 54.1 (95% CI 45.9-63.4) and 27.3 (95% CI 21.3-34.4) events per 1000 patient-days, respectively (P<.001). During both periods, there were no significant changes in the composition of the types of errors (P=.16), and the most common type of error was medication error.</p><p><strong>Conclusions: </strong>ICIS implementation was temporally associated with a 50% reduction in the number and incidence rate of errors in the ICU. Although the most common type of error was medication error in both study periods, ICIS implementation significantly reduced the number and incidence rate of medication errors.</p><p><strong>Trial registration: </strong>University Hospital Medical Information Network Clinical Trials Registry UMIN000041471; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047345.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":"e39782"},"PeriodicalIF":0.0000,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9475405/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR perioperative medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2196/39782","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Although the various advantages of clinical information systems in intensive care units (ICUs), such as intensive care information systems (ICISs), have been reported, their role in preventing medical errors remains unclear.
Objective: This study aimed to investigate the changes in the incidence and type of errors in the ICU before and after ICIS implementation in a setting where a hospital electronic medical record system is already in use.
Methods: An ICIS was introduced to the general ICU of a university hospital. After a step-by-step implementation lasting 3 months, the ICIS was used for all patients starting from April 2019. We performed a retrospective analysis of the errors in the ICU during the 6-month period before and after ICIS implementation by using data from an incident reporting system, and the number, incidence rate, type, and patient outcome level of errors were determined.
Results: From April 2018 to September 2018, 755 patients were admitted to the ICU, and 719 patients were admitted from April 2019 to September 2019. The number of errors was 153 in the 2018 study period and 71 in the 2019 study period. The error incidence rates in 2018 and 2019 were 54.1 (95% CI 45.9-63.4) and 27.3 (95% CI 21.3-34.4) events per 1000 patient-days, respectively (P<.001). During both periods, there were no significant changes in the composition of the types of errors (P=.16), and the most common type of error was medication error.
Conclusions: ICIS implementation was temporally associated with a 50% reduction in the number and incidence rate of errors in the ICU. Although the most common type of error was medication error in both study periods, ICIS implementation significantly reduced the number and incidence rate of medication errors.
Trial registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000041471; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047345.
背景:尽管重症监护病房(icu)的临床信息系统(如重症监护信息系统(ICISs))具有各种优势，但它们在预防医疗差错方面的作用仍不清楚。目的:本研究旨在探讨在医院电子病历系统已投入使用的情况下，实施ICIS前后ICU差错发生率和差错类型的变化。方法:将ICIS应用于某大学医院普通ICU。经过3个月的逐步实施，ICIS从2019年4月开始用于所有患者。我们利用事件报告系统的数据，对ICIS实施前后6个月期间ICU的错误进行回顾性分析，并确定错误的数量、发生率、类型和患者结局水平。结果:2018年4月至2018年9月，ICU收治755例患者;2019年4月至2019年9月，ICU收治719例患者。在2018年的研究期间，错误次数为153次，在2019年的研究期间为71次。2018年和2019年的错误发生率分别为每1000患者日54.1 (95% CI 45.9-63.4)和27.3 (95% CI 21.3-34.4)事件(p结论:ICIS的实施与ICU错误数量和发生率降低50%暂时相关。虽然在两个研究期间最常见的错误类型是用药错误，但ICIS的实施显著降低了用药错误的数量和发生率。试验注册:大学医院医学信息网临床试验注册中心UMIN000041471;https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047345。
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
