{"title":"重症监护病房的药物处方错误:前瞻性观察研究。","authors":"Mandeep Kumar, Neeru Sahni, Nusrat Shafiq, Lakshmi Narayana Yaddanapudi","doi":"10.5005/jp-journals-10071-24148","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The WHO launched a 5-year global initiative to address the problem of medication errors on March 29, 2017, targeting a decrease in severe and avoidable medication-related harm by 50% in all the countries. Since prescription errors are preventable, this study was conducted to determine incidence and severity of medication prescription errors (MPEs).</p><p><strong>Settings and design: </strong>Intensive care unit of a tertiary care academic hospital, prospective observational study.</p><p><strong>Methods and materials: </strong>For all patients admitted in a medical ICU, baseline data (demographic, APACHE II, length of ICU stay, and days of mechanical ventilation) were noted. Treatment charts were reviewed daily, and each prescription was compared against a master chart prepared using standardized references to study the incidence of prescription errors. Severity classification was done using National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) classification. Mean and median, along with standard deviation and interquartile range, were calculated for all quantitative variables. Multivariate linear regression analysis model was used.</p><p><strong>Results: </strong>Out of the total 24,572 medication orders, 2,624 had prescription errors, an error rate of 10.7% (95% CI, 10.3-11.1). When analyzed for severity, 1,757 (7.15%) (95% CI, 6.8-7.5) MPEs did not result in patient harm and 867 (3.52%) (95% CI, 3.3-3.8) MPEs required interventions and/or resulted in patient harm. Patients with deranged creatinine (<i>p</i> <0.001) and INR (<i>p</i> = 0.024) had higher number of severe MPEs.</p><p><strong>Conclusion: </strong>The incidence of MPEs in the medical ICU at the tertiary care hospital was 10.7%, 3.52% being severe errors.</p><p><strong>How to cite this article: </strong>Kumar M, Sahni N, Shafiq N, Yaddanapudi LN. Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study. Indian J Crit Care Med 2022;26(5):555-559.</p>","PeriodicalId":520643,"journal":{"name":"Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine","volume":" ","pages":"555-559"},"PeriodicalIF":1.5000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d1/be/ijccm-26-555.PMC9160616.pdf","citationCount":"2","resultStr":"{\"title\":\"Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study.\",\"authors\":\"Mandeep Kumar, Neeru Sahni, Nusrat Shafiq, Lakshmi Narayana Yaddanapudi\",\"doi\":\"10.5005/jp-journals-10071-24148\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The WHO launched a 5-year global initiative to address the problem of medication errors on March 29, 2017, targeting a decrease in severe and avoidable medication-related harm by 50% in all the countries. Since prescription errors are preventable, this study was conducted to determine incidence and severity of medication prescription errors (MPEs).</p><p><strong>Settings and design: </strong>Intensive care unit of a tertiary care academic hospital, prospective observational study.</p><p><strong>Methods and materials: </strong>For all patients admitted in a medical ICU, baseline data (demographic, APACHE II, length of ICU stay, and days of mechanical ventilation) were noted. Treatment charts were reviewed daily, and each prescription was compared against a master chart prepared using standardized references to study the incidence of prescription errors. Severity classification was done using National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) classification. Mean and median, along with standard deviation and interquartile range, were calculated for all quantitative variables. Multivariate linear regression analysis model was used.</p><p><strong>Results: </strong>Out of the total 24,572 medication orders, 2,624 had prescription errors, an error rate of 10.7% (95% CI, 10.3-11.1). When analyzed for severity, 1,757 (7.15%) (95% CI, 6.8-7.5) MPEs did not result in patient harm and 867 (3.52%) (95% CI, 3.3-3.8) MPEs required interventions and/or resulted in patient harm. Patients with deranged creatinine (<i>p</i> <0.001) and INR (<i>p</i> = 0.024) had higher number of severe MPEs.</p><p><strong>Conclusion: </strong>The incidence of MPEs in the medical ICU at the tertiary care hospital was 10.7%, 3.52% being severe errors.</p><p><strong>How to cite this article: </strong>Kumar M, Sahni N, Shafiq N, Yaddanapudi LN. Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study. 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引用次数: 2
摘要
世卫组织于2017年3月29日启动了一项为期五年的全球行动,以解决用药错误问题,目标是在所有国家将严重和可避免的药物相关伤害减少50%。由于处方错误是可以预防的,因此本研究旨在确定药物处方错误(MPEs)的发生率和严重程度。环境与设计:某三级专科医院重症监护室,前瞻性观察研究。方法和材料:对所有在内科ICU住院的患者,记录基线数据(人口统计学、APACHE II、ICU住院时间和机械通气天数)。每天审查治疗图表,并将每个处方与使用标准化参考文献编制的主图表进行比较,以研究处方错误的发生率。严重性分类采用国家药物错误报告和预防协调委员会(NCCMERP)分类。计算所有定量变量的均值和中位数,以及标准差和四分位间距。采用多元线性回归分析模型。结果:在24572张用药单中,处方错误2624张,错误率为10.7% (95% CI: 10.3 ~ 11.1)。当对严重程度进行分析时,1757例(7.15%)(95% CI, 6.8-7.5)例MPEs没有造成患者伤害,867例(3.52%)(95% CI, 3.3-3.8)例MPEs需要干预和/或导致患者伤害。肌酐紊乱患者(p p = 0.024)发生严重MPEs的次数较多。结论:三级医院内科重症监护病房的差错发生率为10.7%,严重差错发生率为3.52%。本文引自:Kumar M, Sahni N, Shafiq N, Yaddanapudi LN。重症监护病房的药物处方错误:前瞻性观察研究。中华检验医学杂志;2009;26(5):555-559。
Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study.
Introduction: The WHO launched a 5-year global initiative to address the problem of medication errors on March 29, 2017, targeting a decrease in severe and avoidable medication-related harm by 50% in all the countries. Since prescription errors are preventable, this study was conducted to determine incidence and severity of medication prescription errors (MPEs).
Settings and design: Intensive care unit of a tertiary care academic hospital, prospective observational study.
Methods and materials: For all patients admitted in a medical ICU, baseline data (demographic, APACHE II, length of ICU stay, and days of mechanical ventilation) were noted. Treatment charts were reviewed daily, and each prescription was compared against a master chart prepared using standardized references to study the incidence of prescription errors. Severity classification was done using National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) classification. Mean and median, along with standard deviation and interquartile range, were calculated for all quantitative variables. Multivariate linear regression analysis model was used.
Results: Out of the total 24,572 medication orders, 2,624 had prescription errors, an error rate of 10.7% (95% CI, 10.3-11.1). When analyzed for severity, 1,757 (7.15%) (95% CI, 6.8-7.5) MPEs did not result in patient harm and 867 (3.52%) (95% CI, 3.3-3.8) MPEs required interventions and/or resulted in patient harm. Patients with deranged creatinine (p <0.001) and INR (p = 0.024) had higher number of severe MPEs.
Conclusion: The incidence of MPEs in the medical ICU at the tertiary care hospital was 10.7%, 3.52% being severe errors.
How to cite this article: Kumar M, Sahni N, Shafiq N, Yaddanapudi LN. Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study. Indian J Crit Care Med 2022;26(5):555-559.