Lack of weight recording in patients being administered narrow therapeutic index antibiotics: a prospective cross-sectional study.
Lack of weight recording in patients being administered narrow therapeutic index antibiotics: a prospective cross-sectional study.
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DOI：
10.1136/bmjopen-2014-006092
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发表时间：
2015-04-02
期刊：
影响因子：
2.9
通讯作者：
Holmes A
中科院分区：
文献类型：
--
作者：
Charani E;Gharbi M;Hickson M;Othman S;Alfituri A;Frost G;Holmes A
患者体重是安全用药管理和患者监测的关键指标。在这里，我们报告的记录，病人的体重入院时，在西伦敦的三家医院和它的关系，处方抗生素药物，它是必不可少的病人的体重。在西伦敦的三所教学医院进行了一项前瞻性横断面研究。数据收集于2011年3月至2011年9月和2012年7月至2012年8月期间，来自成人入院单位、内科和外科病房。在一天内收集每个病房的数据，以提供体重记录的点患病率数据。对患者用药表、护理和医疗记录进行了审查，以获得记录体重和身高的证据以及为患者开具的所有药物。在两个随机选择的病房进行了一项观察性研究，收集体重记录过程的数据，以增加数据的背景。收集了1012例患者的数据。46%（474）的患者未记录体重。89例患者处方了狭义治疗性抗生素，其中39%（35/89）的患者未记录体重。静脉注射万古霉素是最常用的需要治疗监测的抗生素。共有61例患者接受静脉万古霉素治疗，其中44%（27/61）未记录体重。在观察性研究中，未记录体重的最常见障碍是入院过程中断。尽管体重测量具有临床重要性，但由于工作流程中断和工作人员工作量繁重，住院患者的体重测量记录不佳。在抗生素中，需要正确的近期患者体重以准确给药，并将药物保持在狭窄的治疗指数内，以确保处方的有效性并减少毒性。
Patient weight is a key measure for safe medication management and monitoring of patients. Here we report the recording of patient's body weight on admission in three hospitals in West London and its relationship with the prescription of antibiotic drugs where it is essential to have the body weight of the patient. A prospective cross-sectional study was conducted in three teaching hospitals in West London. Data were collected during March 2011–September 2011 and July 2012–August 2012, from adult admissions units, medical and surgical wards. Data from each ward were collected on a single day to provide a point prevalence data on weight recording. Patient medication charts, nursing and medical notes were reviewed for evidence of weight and height recording together with all the medication prescribed for the patients. An observational study collecting data on the weight recording process was conducted on two randomly selected wards to add context to the data. Data were collected on 1012 patients. Weight was not recorded for 46% (474) of patients. Eighty-nine patients were prescribed a narrow therapeutic antibiotic, in 39% (35/89) of these weight was not recorded for the patient. Intravenous vancomycin was the most commonly prescribed antibiotic requiring therapeutic monitoring. In total 61 patients were receiving intravenous vancomycin and of these 44% (27/61) did not have their weight recorded. In the observational study, the most frequently identified barrier to weight not being recorded was interruptions to the admission process. Despite the clinical importance of body weight measurement it is poorly recorded in hospitalised patients, due to interruptions to the workflow and heavy staff workloads. In antibiotics a correct, recent patient weight is required for accurate dosing and to keep drugs within the narrow therapeutic index, to ensure efficacy of prescribing and reduce toxicity.
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影响因子：
13.3
作者：
Campbell, SE;Avenell, A;Walker, AE
通讯作者：
Walker, AE
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作者：
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通讯作者：
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作者：
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作者：
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通讯作者：
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