Likelihood of reporting medication errors in hospitalized children: a survey of nurses and physicians
Likelihood of reporting medication errors in hospitalized children: a survey of nurses and physicians
复制标题
报告住院儿童用药错误的可能性：对护士和医生的调查
DOI：
--
复制
发表时间：
2018
影响因子：
4.4
通讯作者：
A. Almarsdóttir
中科院分区：
文献类型：
--
作者：
R. Rishoej;J. Hallas;Lene Juel Kjeldsen;Henrik Thybo Christesen;A. Almarsdóttir
背景：由于剂量计算和准备复杂，住院儿童面临用药错误（ME）的风险。事故报告制度可能有助于预防ME，但报告不足可能会破坏这一制度。我们的目的是研究是否应该向国家强制性事件报告系统报告涉及药物的情况，以及儿科护士和医生自我和同行报告这些情况的可能性。方法：通过涉及20种药物方案的问卷调查，探讨参与者对ME的报告。这些场景代表了用药过程中的不同步骤、错误类型、患者结局和药物。计算报告率和比值比及95%置信区间[OR，（95% CI）]。通过对与会者评论的内容分析，查明了报告的障碍和推动因素。结果有效率为42%（291/689）。总体而言，61%的参与者表示应报告情景。自我报告的可能性为60%，同行报告的可能性为37%。护士与医生，以及有与没有患者安全责任的医疗保健专业人员在更大程度上评估了应报告的情景[OR = 1.34（1.05-1.70），OR = 1.41（1.12-1.78）];更倾向于自我报告，[OR = 2.81（1.71-4.62）和OR = 2.93（1.47-5.84）];更可能进行同行报告[OR = 1.89（1.36-2.63）和OR = 3.61（2.57-5.06）]。有管理责任的医疗保健专业人员与无管理责任的医疗保健专业人员相比，更有可能进行同行报告[OR = 5.16（3.44-7.72）]。与会者报告说，应报告造成实际伤害的情景或被认为具有学习潜力的事件。结论：在儿科护士和医生中，漏报情况的可能性很高。护士和工作人员与病人的安全责任更有可能评估的情况下，应报告和报告。有实际伤害或学习潜力的事件更有可能被报告。提高涉及中小企业的报告率的潜力似乎很大。
Background: Hospitalized children are at risk of medication errors (MEs) due to complex dosage calculations and preparations. Incident reporting systems may facilitate prevention of MEs but underreporting potentially undermines this system. We aimed to examine whether scenarios involving medications should be reported to a national mandatory incident reporting system and the likelihood of self- and peer-reporting these scenarios among paediatric nurses and physicians. Methods: Participants’ reporting of MEs was explored through a questionnaire involving 20 medication scenarios. The scenarios represented different steps in the medication process, types of error, patient outcomes and medications. Reporting rates and odds ratios with 95% confidence interval [OR, (95% CI)] were calculated. Barriers to and enablers of reporting were identified through content analysis of participants’ comments. Results The response rate was 42% (291/689). Overall, 61% of participants reported that scenarios should be reported. The likelihood of reporting was 60% for self-reporting and 37% for peer-reporting. Nurses versus physicians, and healthcare professionals with versus without patient safety responsibilities assessed to a larger extent that the scenarios should be reported [OR = 1.34 (1.05–1.70) and OR = 1.41 (1.12–1.78), respectively]; were more likely to self-report, [OR = 2.81 (1.71–4.62) and OR = 2.93 (1.47–5.84), respectively]; and were more likely to peer-report [OR = 1.89 (1.36–2.63) and OR = 3.61 (2.57–5.06), respectively]. Healthcare professionals with versus without management responsibilities were more likely to peer-report [OR = 5.16 (3.44–7.72)]. Participants reported that scenarios resulting in actual injury or incidents considered to have a learning potential should be reported. Conclusion: The likelihood of underreporting scenarios was high among paediatric nurses and physicians. Nurses and staff with patient safety responsibilities were more likely to assess that scenarios should be reported and to report. Incidents with actual injury or learning potential were more likely to be reported. The potential for improving reporting rates involving MEs seems high.