了解处方错误以优化系统:与技术相关的错误机制分类。

IF 4.1 Q1 HEALTH CARE SCIENCES & SERVICES
Magdalena Z Raban, Alison Merchant, Erin Fitzpatrick, Melissa T Baysari, Ling Li, Peter Gates, Johanna I Westbrook
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引用次数: 0

摘要

目标:与技术相关的处方错误会削弱计算机化医嘱输入 (CPOE) 对用药安全的积极影响。了解与技术相关的错误 (TRE) 是如何发生的,可以为 CPOE 的优化提供依据。此前,我们利用两家成人医院的处方错误数据,对 TRE 的基本机制进行了分类。我们的目标是利用儿科处方错误数据更新该分类,并评估审查员独立应用该分类的可靠性:利用一家三级儿科医院 2016 年和 2017 年通过病历审查发现的 1696 例处方错误数据,我们确定了与技术相关的错误。我们对这些错误进行了调查,并使用之前开发的分类方法对其基本机制进行了分类,还根据数据增加了新的类别。对技术相关错误的识别和分类采用了两步法,包括审查 CPOE 中的错误和在 CPOE 测试环境中模拟错误:技术相关错误机制(TREM)分类包括六个机制类别、一个促成因素和 19 个子类别。这些类别如下(1) 错误的系统配置或系统故障,(2) 打开或使用错误的病历,(3) 选择错误,(4) 构建错误,(5) 编辑错误,(6) 使用不同于纸质系统的工作流程时发生的错误,(7) 促成因素:使用混合系统:TRE 仍是 CPOE 的一个关键问题。更新后的 TREM 分类提供了评估和监控 TRE 的系统方法,可为系统改进提供信息并确定优先次序,现在已针对儿科环境进行了更新。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Understanding prescribing errors for system optimisation: the technology-related error mechanism classification.

Objectives: Technology-related prescribing errors curtail the positive impacts of computerised provider order entry (CPOE) on medication safety. Understanding how technology-related errors (TREs) occur can inform CPOE optimisation. Previously, we developed a classification of the underlying mechanisms of TREs using prescribing error data from two adult hospitals. Our objective was to update the classification using paediatric prescribing error data and to assess the reliability with which reviewers could independently apply the classification.

Materials and methods: Using data on 1696 prescribing errors identified by chart review in 2016 and 2017 at a tertiary paediatric hospital, we identified errors that were technology-related. These errors were investigated to classify their underlying mechanisms using our previously developed classification, and new categories were added based on the data. A two-step process was used to identify and classify TREs involving a review of the error in the CPOE and simulating the error in the CPOE testing environment.

Results: The technology-related error mechanism (TREM) classification comprises six mechanism categories, one contributing factor and 19 subcategories. The categories are as follows: (1) incorrect system configuration or system malfunction, (2) opening or using the wrong patient record, (3) selection errors, (4) construction errors, (5) editing errors, (6) errors that occur when using workflows that differ from a paper-based system (7) contributing factor: use of hybrid systems.

Conclusion: TREs remain a critical issue for CPOE. The updated TREM classification provides a systematic means of assessing and monitoring TREs to inform and prioritise system improvements and has now been updated for the paediatric setting.

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来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
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