儿科急诊科患者抗生素验证和制备的药房优化:一项质量改进项目。

Q2 Medicine
Esther Esadah, Elizabeth Ferguson, Kevin Ordons, Jennifer Woodring, Johanna Rosen
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引用次数: 0

摘要

目的:本项目的主要目的是提高急诊科(ED)抗生素的前瞻性药学验证率。我们还旨在简化静脉注射(IV)抗生素制备和递送的过程,而不会造成抗生素给药的重大延误。方法:回顾性评价2021年9月至2022年4月干预前后静脉注射和口服抗生素的药师单验证率。主要干预措施包括修改药剂师验证队列和工作流程优先级。流程度量包括从订单放置到药房验证、药房交付和管理的时间。采用Mann-Whitney U检验对工艺变更前后的中位数时间进行统计分析。控制图用于说明在规定的时间内干预的效果。结果:评估期间,ED共下单静脉注射和口服抗生素2545剂,流程改变导致给药前审核的静脉注射和口服抗生素订单数量从63%(875/1388)增加到93%(1076/1157)。药房IV抗生素订单验证的中位数时间从21分钟大幅减少到7分钟(IQR, 4-13;p < 0.05),静脉给药时间中位数从43分钟增加到27分钟(IQR, 18-38;P < 0.05)。第一次静脉注射抗生素的总时间基本上不受工艺变化的影响(50分钟vs 51分钟;P = 0.16)。结论:在急诊科等高锐度环境下实施强制药房审核和静脉注射剂量制备是可行的,且不影响抗生素给药次数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pharmacy Optimization of Antibiotic Verification and Preparation for Pediatric Emergency Department Patients: A Quality Improvement Project.

Objectives: The primary aim of this project was to improve the rate of prospective pharmacy verification of antibiotics in the emergency department (ED). We also aimed to streamline the process for intravenous (IV) antibiotic preparation and delivery without causing significant delays in antibiotic administration.

Methods: This retrospective evaluation compared pharmacist order verification rates for IV and oral antibiotics pre and post intervention between September 2021 and April 2022. Primary intervention involved modifications to the pharmacist verification queue and workflow prioritization. Process measures included time from order placement to pharmacy verification, pharmacy delivery, and administration. Statistical analysis of median times before and after the process change was conducted by using the Mann-Whitney U test. Control charts were used to illustrate the effect of the intervention over the defined period.

Results: During the evaluation period, a total of 2545 IV and oral antibiotic doses were ordered in the ED. The process change resulted in an increase in the number of ED IV and oral antibiotic orders verified before administration from 63% (875/1388) to 93% (1076/1157). There were substantial reductions in the pharmacy's median time to IV antibiotic order verification from 21 minutes to 7 minutes (IQR, 4-13; p < 0.05), and median time to IV antibiotic order delivery from 43 minutes to 27 minutes (IQR, 18-38; p < 0.05). Overall time to the first administrated IV antibiotic remained largely unaffected by the process change (50 vs 51 minutes; p = 0.16).

Conclusion: Implementation of mandatory pharmacy verification and preparation of IV doses in a high acuity environment like the ED is feasible without compromising antibiotic administration times.

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来源期刊
Journal of Pediatric Pharmacology and Therapeutics
Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
2.40
自引率
0.00%
发文量
90
期刊介绍: The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.
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