Medication reconciliation: A practical tool to reduce the risk of medication errors
Medication reconciliation: A practical tool to reduce the risk of medication errors
复制标题
DOI：
10.1016/j.jcrc.2003.10.001
复制
发表时间：
2003-12-01
影响因子：
3.7
通讯作者：
Lipsett, P
中科院分区：
文献类型：
--
作者：
Pronovost, P;Weast, B;Lipsett, P
可预防的药物不良事件与五分之一的伤害或死亡有关。据估计，46% 的用药错误发生在临床单位/医院入院或出院时书写患者医嘱时。进行这项研究的目的是通过成人外科重症监护病房 (ICU) 的协调流程来减少患者出院单中的用药错误。作为药物协调过程的一部分，实施了出院调查。入院护士在入住 ICU 后 24 小时内发起调查，主管护士在出院时完成调查。基线数据是通过在研究的前两周（2001 年 7 月至 2002 年 5 月）内对 10% 的出院者进行随机抽样获得的。审查医疗和麻醉记录，与患者/家属核实过敏和家庭药物，并将结果与 ICU 出院时的订单进行比较。基线数据显示，33 名患者中有 31 名 (94%) 的医嘱发生了变化。到第 24 周，出院单中几乎所有用药错误都已消除。总之，在药物协调过程中使用出院调查可以使 ICU 出院患者的用药错误大幅减少。该调查现已成为我们电子病历的一部分，并在 4 个成人 ICU 和 2 个药房使用。 (C) 2003 Elsevier Inc. 保留所有权利。
Preventable adverse drug events are associated with one out of five injuries or deaths. Estimates reveal that 46% of medication errors occur on admission or discharge from a clinical unit/hospital when patient orders are written. This study was performed to reduce medication errors in patient's discharge orders through a reconciliation process in an adult surgical intensive care unit (ICU). A discharge survey was implemented as part of the medication reconciliation process. The admitting nurse initiated the survey within 24 hours of ICU admission and the charge nurse completed the survey on discharge. Baseline data were obtained through a random sampling of 10% of discharges in first 2 weeks of the study (July 2001-May 2002). Medical and anesthesia records were reviewed, allergies and home medications verified with patient/family and findings compared with orders at time of ICU discharge. Baseline data revealed that 31 of 33 (94%) patients had orders changed. By week 24, nearly all medication errors in discharge orders were eliminated. In conclusion, use of the discharge survey in this medication reconciliation process resulted in a dramatic drop in medications errors for patients discharged from an ICU. The survey is now a part of our electronic medical record and used in 4 adult ICUs and 2 medicine floors. (C) 2003 Elsevier Inc. All rights reserved.