Preventable adverse drug events in hospitalized patients: A comparative study of intensive care and general care units
Preventable adverse drug events in hospitalized patients: A comparative study of intensive care and general care units
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DOI：
10.1097/00003246-199708000-00014
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发表时间：
1997-08-01
影响因子：
8.8
通讯作者：
Leape, LL
中科院分区：
文献类型：
--
作者：
Cullen, DJ;Sweitzer, BJ;Leape, LL
目的：比较重症监护病房（ICU）和非 ICU 中药物不良事件和潜在药物不良事件的发生频率和可预防性。通过比较 ICU 与非 ICU 以及内科 ICU 与外科 ICU，评估涉及每个药物不良事件的个体护理人员、护理单位团队和患者的系统因素。设计：前瞻性队列研究。参与者包括 6 个月内入住两家三级医院 11 个内科和外科病房的分层、随机样本的全部 4,031 名成人，病房包括两个内科和三个外科 ICU，以及四个内科和两个外科普通护理病房。设置：两家三级护理医院：11 个内科和外科科室，包括两个内科和三个外科 ICU。患者：成人入院 (n = 4,031)。干预措施：无。测量和主要结果：可预防的药物不良事件和潜在药物不良事件的发生率、住院时间、收费、成本以及单位环境的措施。事件是通过护士和药剂师的刺激自我报告以及护士调查员对所有图表的每日审查来发现的。随后由两名独立评审员对事件进行分类，以确定它们是否代表药物不良事件或潜在的药物不良事件以及严重性和可预防性。参与可预防药物不良事件和潜在药物不良事件的个人接受了同行病例调查员的详细访谈。 ICU 中可预防药物不良事件和潜在药物不良事件的发生率为每 1000 个患者日 19 起，几乎是非 ICU 的两倍（p
Objectives: To compare the frequency and preventability of adverse drug events and potential adverse drug events in inten- sive care units (ICUs) and non-ICUs. To evaluate systems factors involving the individual caregivers, care unit teams, and patients involved in each adverse drug event by comparing ICUs with non-ICUs and medical ICUs with surgical ICUs.Design: Prospective cohort study. Participants included all 4,031 adult admissions to a stratified, random sample of 11 medical and surgical units in two tertiary care hospitals over a 6-month period, Units included two medical and three surgical ICUs and four medical and two surgical general care units.Setting: Two tertiary care hospitals: Eleven medical and surgical units, including two medical and three surgical ICUs.Patients: Adult admissions (n = 4,031).Interventions: None.Measurements and Main Results: Rate of preventable adverse drug events and potential adverse drug events, length of stay, charges, costs, and measures of the unit's environment. Incidents were detected by stimulated self-report by nurses and pharmacists and by daily review of all charts by nurse investigators. Incidents were subsequently classified by two independent reviewers as to whether they represented adverse drug events or potential adverse drug events and as to severity and preventability. Those individuals involved in the preventable adverse drug event and potential adverse drug event underwent detailed interviews by peer case-investigators.The rate of preventable adverse drug events and potential adverse drug events in ICUs was 19 events per 1000 patient days, nearly twice that rate of non-ICUs (p