Intensive Care Medicine最新文献_第6页

Understanding and mitigating medication errors associated with patient harm in adult intensive care units: a scoping review 理解和减轻与成人重症监护病房患者伤害相关的用药错误：一项范围综述

IF 38.9 1区医学

Intensive Care Medicine Pub Date : 2025-05-20 DOI: 10.1007/s00134-025-07938-6

Kathryn Puxty, Margo van Mol, María Cruz Martin Delgado, Michael Darmon, Ricardo Ferrer, Alessandro Galazzi, Entela Kondi, Lene Russell, Elena Sancho, Marlies Ostermann, Elie Azoulay, Richard S. Bourne

{"title":"Understanding and mitigating medication errors associated with patient harm in adult intensive care units: a scoping review","authors":"Kathryn Puxty, Margo van Mol, María Cruz Martin Delgado, Michael Darmon, Ricardo Ferrer, Alessandro Galazzi, Entela Kondi, Lene Russell, Elena Sancho, Marlies Ostermann, Elie Azoulay, Richard S. Bourne","doi":"10.1007/s00134-025-07938-6","DOIUrl":"https://doi.org/10.1007/s00134-025-07938-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Medication interventions are fundamental to the care of the critically ill patient in the intensive care unit (ICU), relying on effective and appropriate delivery of the medication use process. Medication errors affect a high proportion of patients in the ICU. This scoping review maps the literature pertaining to medication errors and preventable adverse drug events in the adult ICU.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We searched seven electronic databases (PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, Cochrane, Google Scholar), identifying 2960 records. After screening against predefined eligibility criteria, 48 records were included for data extraction.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A high variation in incidence of medication errors and preventable adverse drug events were reported, reflecting the heterogeneity in study designs, surveillance methods and preventability assessments. Associated risks factors include patient (high severity of illness, older age), clinical (renal dysfunction, prolonged ICU stay), staff (staff inexperience, role overload), environmental (interruptions, transfer of care) in addition to high-risk medications. The rate of serious or life-threatening harm was low at 1–5% of all medication errors. Half (<i>n</i> = 11, 55%) of the interventions or mitigation practices were focused on the medication prescription phase.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Most medication errors in ICU are identified and intercepted by systems and staff. A minority lead to preventable patient harm and increased length of stay. Decision support embedded in e-prescribing systems, medication reconciliation and review processes and clinical pharmacist activities reduce medication errors and patient harm.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"78 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}