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Abdelaziz S, Amigoni A, Kurttila M, Laaksonen R, Silvari V, Franklin BD. Medication safety strategies in European adult, paediatric, and neonatal intensive care units: a cross-sectional survey. Eur J Hosp Pharm 2024:ejhpharm-2023-004018. [PMID: 38834286 DOI: 10.1136/ejhpharm-2023-004018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/02/2024] [Indexed: 06/06/2024] Open
Abstract
OBJECTIVES Patients in intensive care units (ICUs) are potentially more vulnerable to medication errors than patients admitted to general wards. However, little is known about medication safety strategies used in European ICUs. Our objectives were to explore the strategies being used and being planned within European ICUs, to identify areas of variation, and to inform recommendations to improve medication safety in this patient group. METHODS We distributed an online survey, in seven European languages, via professional networks and social media. The survey explored a range of medication safety strategies and whether they were in use (and if so, whether fully or partially implemented) or being planned. Demographic information about respondents and their ICUs was also captured. A descriptive analysis was conducted, which included exploring geographical variation. RESULTS We obtained 587 valid responses from 32 different countries, with 317 (54%) completed by pharmacy staff. Medication safety practices most commonly implemented were patients' allergies being visible for all staff involved in their care (fully implemented in 382 (65%) of respondents' ICUs), standardised emergency medication stored in a fixed place (337, 57%), and use of standardised medication concentrations for commonly used intravenous infusions (330, 56%). Electronic prescribing systems were fully implemented in 310 (53%). A pharmacist was reported to be fully implemented in 181 (31%) of ICUs, of which there was 126 (70%) where there was a pharmacist review of all ordered medication five days per week. Critical care pharmacists were most common in Northern European ICUs (fully implemented to ICUs in 102, 50%) and electronic prescribing in Western Europe (108, 65%). CONCLUSIONS There is considerable variation in medication safety strategies used within European ICUs, both between and within geographical areas. Our findings may be helpful to ICU staff in identifying strategies that should be considered for implementation.
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Affiliation(s)
- Shahd Abdelaziz
- Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
| | - Angela Amigoni
- Department of Women's and Child's Health, University Hospital of Padova, Padova, Italy
| | - Minna Kurttila
- Hospital Pharmacy of Kuopio University Hospital, Kuopio University Hospital, Kuopio, Finland
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Raisa Laaksonen
- Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Virginia Silvari
- Pharmacy Department, Cork University Hospital, Cork, Ireland
- School of Pharmacy, University College Cork, Cork, Ireland
| | - Bryony Dean Franklin
- Pharmacy Department, Imperial College Healthcare NHS Trust, London, UK
- School of Pharmacy, University College London, London, UK
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Carter M, Abutheraa N, Ivers N, Grimshaw J, Chapman S, Rogers P, Simeoni M, Antony J, Watson MC. Audit and feedback interventions involving pharmacists to influence prescribing behaviour in general practice: a systematic review and meta-analysis. Fam Pract 2023; 40:615-628. [PMID: 36633309 PMCID: PMC10745261 DOI: 10.1093/fampra/cmac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Pharmacists, as experts in medicines, are increasingly employed in general practices and undertake a range of responsibilities. Audit and feedback (A&F) interventions are effective in achieving behaviour change, including prescribing. The extent of pharmacist involvement in A&F interventions to influence prescribing is unknown. This review aimed to assess the effectiveness of A&F interventions involving pharmacists on prescribing in general practice compared with no A&F/usual care and to describe features of A&F interventions and pharmacist characteristics. METHODS Electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, (Social) Science Citation Indexes, ISI Web of Science) were searched (2012, 2019, 2020). Cochrane systematic review methods were applied to trial identification, selection, and risk of bias. Results were summarized descriptively and heterogeneity was assessed. A random-effects meta-analysis was conducted where studies were sufficiently homogenous in design and outcome. RESULTS Eleven cluster-randomized studies from 9 countries were included. Risk of bias across most domains was low. Interventions focussed on older patients, specific clinical area(s), or specific medications. Meta-analysis of 6 studies showed improved prescribing outcomes (pooled risk ratio: 0.78, 95% confidence interval: 0.64-0.94). Interventions including both verbal and written feedback or computerized decision support for prescribers were more effective. Pharmacists who received study-specific training, provided ongoing support to prescribers or reviewed prescribing for individual patients, contributed to more effective interventions. CONCLUSIONS A&F interventions involving pharmacists can lead to small improvements in evidence-based prescribing in general practice settings. Future implementation of A&F within general practice should compare different ways of involving pharmacists to determine how to optimize effectiveness.PRISMA-compliant abstract included in Supplementary Material 1.
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Affiliation(s)
- Mary Carter
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | - Nouf Abutheraa
- School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Noah Ivers
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Jeremy Grimshaw
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sarah Chapman
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | - Philip Rogers
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | | | - Jesmin Antony
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Margaret C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
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Interventions to Reduce Pediatric Prescribing Errors in Professional Healthcare Settings: A Systematic Review of the Last Decade. Paediatr Drugs 2021; 23:223-240. [PMID: 33959936 DOI: 10.1007/s40272-021-00450-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pediatric medication therapy is prone to errors due to the need for pharmacokinetic and pharmacodynamic individualization and the diverse settings in which pediatric patients are treated. Prescribing errors have been reported as the most common medication error. OBJECTIVES The aim of this review was to systematically identify interventions to reduce prescribing errors and corresponding patient harm in pediatric healthcare settings and to evaluate their impact. METHODS Four databases were systematically screened (time range November 2011 to December 2019), and experimental studies were included. Interventions to reduce prescribing errors were extracted and classified according to a 'hierarchy of controls' model. RESULTS Forty-five studies were included, and 70 individual interventions were identified. A bundle of interventions was more likely to reduce prescribing errors than a single intervention. Interventions classified as 'substitution or engineering controls' were more likely to reduce errors in comparison with 'administrative controls', as is expected from the hierarchy of controls model. Fourteen interventions were classified as substitution or engineering controls, including computerized physician order entry (CPOE) and clinical decision support (CDS) systems. Administrative controls, including education, expert consultations, and guidelines, were more commonly identified than higher level controls, although they may be less likely to reduce errors. Of the administrative controls, expert consultations were most likely to reduce errors. CONCLUSIONS Interventions to reduce pediatric prescribing errors are more likely to be successful when implemented as part of a bundle of interventions. Interventions including CPOE and CDS that substitute risks or provide engineering controls should be prioritized and implemented with appropriate administrative controls including expert consultation.
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Johnston K, Ankravs MJ, Badman B, Choo CL, Cree M, Fyfe R, Roberts JA, Xu J, Munro C. Standard of practice in intensive care for pharmacy services. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2021. [DOI: 10.1002/jppr.1718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Karlee Johnston
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Australian National University Medical School Garran Australia
- Canberra Hospital Garran Australia
| | - Melissa J. Ankravs
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Pharmacy Department and Intensive Care Unit Royal Melbourne Hospital Parkville Australia
- Department of Medicine and Radiology Melbourne Medical School Royal Melbourne Hospital The University of Melbourne Parkville Australia
| | - Belinda Badman
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Princess Alexandra Hospital Metro South Health Service Brisbane Australia
| | - Chui Lynn Choo
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Pharmacy Department and Intensive Care Services John Hunter Hospital New Lambton Heights Australia
| | - Michele Cree
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Queensland Children’s Hospital and Children’s Health Brisbane Australia
| | - Rachel Fyfe
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Pharmacy Department and Intensive Care Unit Barwon Health Geelong Australia
| | - Jason A. Roberts
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Faculty of Medicine & Centre for Translational Anti‐infective Pharmacodynamics School of Pharmacy The University of Queensland Centre for Clinical Research The University of Queensland Brisbane Australia
- Departments of Pharmacy and Intensive Care Medicine Royal Brisbane and Women’s Hospital Brisbane Australia
| | - Jessica Xu
- Critical Care Leadership Committee The Society of Hospital Pharmacists of Australia Collingwood Australia
- Pharmacy Department Fiona Stanley Hospital Perth Australia
| | - Courtney Munro
- The Society of Hospital Pharmacists of Australia Collingwood Australia
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Koeck JA, Young NJ, Kontny U, Orlikowsky T, Bassler D, Eisert A. Interventions to Reduce Medication Dispensing, Administration, and Monitoring Errors in Pediatric Professional Healthcare Settings: A Systematic Review. Front Pediatr 2021; 9:633064. [PMID: 34123962 PMCID: PMC8187621 DOI: 10.3389/fped.2021.633064] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 04/12/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: Pediatric patients cared for in professional healthcare settings are at high risk of medication errors. Interventions to improve patient safety often focus on prescribing; however, the subsequent stages in the medication use process (dispensing, drug administration, and monitoring) are also error-prone. This systematic review aims to identify and analyze interventions to reduce dispensing, drug administration, and monitoring errors in professional pediatric healthcare settings. Methods: Four databases were searched for experimental studies with separate control and intervention groups, published in English between 2011 and 2019. Interventions were classified for the first time in pediatric medication safety according to the "hierarchy of controls" model, which predicts that interventions at higher levels are more likely to bring about change. Higher-level interventions aim to reduce risks through elimination, substitution, or engineering controls. Examples of these include the introduction of smart pumps instead of standard pumps (a substitution control) and the introduction of mandatory barcode scanning for drug administration (an engineering control). Administrative controls such as guidelines, warning signs, and educational approaches are lower on the hierarchy and therefore predicted by this model to be less likely to be successful. Results: Twenty studies met the inclusion criteria, including 1 study of dispensing errors, 7 studies of drug administration errors, and 12 studies targeting multiple steps of the medication use process. A total of 44 interventions were identified. Eleven of these were considered higher-level controls (four substitution and seven engineering controls). The majority of interventions (n = 33) were considered "administrative controls" indicating a potential reliance on these measures. Studies that implemented higher-level controls were observed to be more likely to reduce errors, confirming that the hierarchy of controls model may be useful in this setting. Heterogeneous study methods, definitions, and outcome measures meant that a meta-analysis was not appropriate. Conclusions: When designing interventions to reduce pediatric dispensing, drug administration, and monitoring errors, the hierarchy of controls model should be considered, with a focus placed on the introduction of higher-level controls, which may be more likely to reduce errors than the administrative controls often seen in practice. Trial Registration Prospero Identifier: CRD42016047127.
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Affiliation(s)
- Joachim A Koeck
- Hospital Pharmacy, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany
| | - Nicola J Young
- Hospital Pharmacy, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany
| | - Udo Kontny
- Section of Pediatric Hematology, Department of Pediatric and Adolescent Medicine, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany
| | - Thorsten Orlikowsky
- Section of Neonatology, Department of Pediatric and Adolescent Medicine, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Albrecht Eisert
- Hospital Pharmacy, Rheinisch-Westfälische Technische Hochschule Aachen University Hospital, Aachen, Germany.,Institute of Clinical Pharmacology, University Hospital of Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
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Cheng W, Wang C, Ma J, Ji W, Yang X, Wu B, Hou R. Satisfaction and needs of pharmacists in prescription-checking training: a cross-sectional survey. J Int Med Res 2020; 48:300060520965810. [PMID: 33131364 PMCID: PMC7653297 DOI: 10.1177/0300060520965810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Prescription checking is becoming increasingly prevalent in medical institutions. However, the prescription-checking ability of pharmacists requires improvement. The study aim was to explore the main aspects of prescription-checking training and provide an empirical reference for the training of pharmacists in medical institutions. METHODS Participants were pharmacists willing to complete a Likert questionnaire. Descriptive statistics were used to examine percentages and composition ratios. The chi-square test and exploratory factor analysis were used for inferential analysis. RESULTS The questionnaire showed good internal consistency reliability and validity. A total of 90% of participants were satisfied with the training. Exploratory factor analysis extracted three satisfaction dimensions: training organization, teaching method, and knowledge consolidation and assessment. The average examination score for the 20 courses was 89.21/100. Regarding trainee needs, 94.66% preferred face-to-face lectures, 89.33% expected high professional skills of the lecturers and 62.67% believed that clinical expertise was highly desirable. CONCLUSIONS There was a high demand for prescription-checking training among pharmacists. Trainees in this study showed high satisfaction. The most important aspects of prescription-checking training were training organization and knowledge consolidation and assessment. It is recommended that training should be stratified. Pharmacists preferred face-to-face and interactive lectures as a supplement to clinical knowledge.
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Affiliation(s)
- Wei Cheng
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chen Wang
- Department of Pharmacy, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Jing Ma
- Department of Medical Cases and Statistics, Shanxi Cardiovascular Hospital, Taiyuan, Shanxi, China
| | - Wen Ji
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiangli Yang
- Department of Radiology, Shanxi Baiqiuen Hospital, Taiyuan, Shanxi, China
| | - Bei Wu
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Ruigang Hou
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
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den Hollander B, Linssen RSN, Cortjens B, van Etten-Jamaludin FS, van Woensel JBM, Bem RA. Use of dornase alfa in the paediatric intensive care unit: current literature and a national cross-sectional survey. Eur J Hosp Pharm 2020; 29:123-128. [PMID: 33122405 PMCID: PMC9047925 DOI: 10.1136/ejhpharm-2020-002507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 11/06/2022] Open
Abstract
Objectives Airway mucus obstruction is a major challenge in children admitted to the paediatric intensive care unit (PICU). We aimed to evaluate the evidence and contemporary use of the mucolytic medication dornase alfa for non-cystic fibrosis conditions in the PICU. Methods (1) We performed a systematic review with searches in PubMed, EMBASE, and the Cochrane Library. Study selection: for quality assessment and data synthesis, we included only randomised controlled trials (RCTs) that compared dornase alfa to standard care or placebo in critically-ill paediatric patients (<18 years of age) in the PICU. However, non-randomised controlled studies and case series are also discussed. Data extraction: data were extracted independently by multiple reviewers using data extraction forms. The primary outcome was duration of mechanical ventilation. Data synthesis: The GRADE approach was used for quality assessment. No meta-analysis could be performed. (2) A national cross-sectional survey among all seven PICUs in the Netherlands was also performed. Results The systematic review yielded only one RCT, comparing dornase alfa with normal saline in children after cardiac surgery. In this study, dornase alfa led to a reduction in duration of mechanical ventilation by approximately 1 day (36% reduction). In addition, we found nine retrospective observational and case studies. The survey revealed high current use of dornase alfa in Dutch PICUs: 42% of the respondents reported prescribing dornase alfa at least once every week. Only 4% of the respondents reported having access to a local PICU dornase alfa protocol. Conclusions The off-label use of dornase alfa in the PICU is frequent without strong evidence or local protocols, highlighting the need for further research on the effectiveness of this mucolytic agent.
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Affiliation(s)
- Bibiche den Hollander
- Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Rosalie S N Linssen
- Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Bart Cortjens
- Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | | | - Job B M van Woensel
- Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Reinout A Bem
- Pediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
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Safaie N, Azizi H, Khiali S, Entezari-Maleki T. The Impact of Clinical Pharmacist Interventions on Medication Errors Management in the Postoperative Cardiac Intensive Care Unit. PHARMACEUTICAL SCIENCES 2020. [DOI: 10.34172/ps.2020.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Medication errors (MEs) frequently occur in intensive care unit (ICU) admittedpatients. The present study aimed to evaluate the frequency and types of MEs in an open heartsurgery heart ICU and clinical pharmacists’ role in the management of them. Methods: This cross-sectional, observational study was performed from October 2016 toMarch 2017 in the Shahid Madani Heart Center. A clinical pharmacist reviewed patients’ files,laboratory data, and physician orders during morning hours. All of the MEs and the clinicalpharmacies’ recommendations for the management of them were analyzed. Results: A total of 311 MEs were observed in the medical files of 152 patients. The rate of MEswas 2.04 errors per patient and 0.19 errors per ordered medication. The acceptance rate of MEswas 72.6%. The most type of MEs was ‘forgot to order’ (75 cases, 24.1%) followed by "wrongfrequency" and "adding a drug" in 56 (18%) and 49 (15.8) patients, respectively. Most MEs wereinsignificant. Conclusion: MEs occur at different stages of the therapeutic process in the postoperative cardiacintensive care unit, and clinical pharmacists play an essential role in detecting and managingMEs.
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Affiliation(s)
- Naser Safaie
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Azizi
- Depaatment of Clinical Pharmacy, Drug Applied Research Center, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sajad Khiali
- Depaatment of Clinical Pharmacy, Drug Applied Research Center, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taher Entezari-Maleki
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Depaatment of Clinical Pharmacy, Drug Applied Research Center, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
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Gates PJ, Baysari MT, Gazarian M, Raban MZ, Meyerson S, Westbrook JI. Prevalence of Medication Errors Among Paediatric Inpatients: Systematic Review and Meta-Analysis. Drug Saf 2020; 42:1329-1342. [PMID: 31290127 DOI: 10.1007/s40264-019-00850-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The risk of medication errors is high in paediatric inpatient settings. However, estimates of the prevalence of medication errors have not accounted for heterogeneity across studies in error identification methods and definitions, nor contextual differences across wards and the use of electronic or paper medication charts. OBJECTIVE Our aim was to conduct a systematic review and meta-analysis to provide separate estimates of the prevalence of medication errors among paediatric inpatients, depending on hospital ward and the use of electronic or paper medication charts, that address differences in error identification methods and definitions. METHODS We systematically searched five databases to identify studies published between January 2000 and December 2018 that assessed medication error rates by medication chart audit, direct observation or a combination of methods. RESULTS We identified 71 studies, 19 involved paediatric wards using electronic charts. Most studies assessed prescribing errors with few studies assessing administration errors. Estimates varied by ward type. Studies of paediatric wards using electronic charts generally reported a reduced error prevalence compared to those using paper, although there were some inconsistencies. Error detection methods impacted the rate of administration errors in studies of multiple wards, however, no other difference was found. Definition of medication error did not have a consistent impact on reported error rates. CONCLUSIONS Medication errors are a frequent occurrence in paediatric inpatient settings, particularly in intensive care wards and emergency departments. Hospitals using electronic charts tended to have a lower rate of medication errors compared to those using paper charts. Future research employing controlled designs is needed to determine the true impact of electronic charts and other interventions on medication errors and associated harm among hospitalized children.
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Affiliation(s)
- Peter J Gates
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
| | - Melissa T Baysari
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Madlen Gazarian
- School of Medical Sciences, Faculty of Medicine, University of NSW Sydney, Sydney, Australia
| | - Magdalena Z Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Sophie Meyerson
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
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Owari Y, Miyatake N, Suzuki H. Decrease in blood donation rates in Japan: a time series analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200047. [PMID: 32491049 DOI: 10.1590/1980-549720200047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/20/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To clarify that one of the causes for the decrease in blood donation (BD) rates was the introduction of the 400 ml BD program in 1986. METHOD BP rates were monitored over 48 years (1965-2012) and were divided into pre- and post-intervention periods prior to analysis. An interrupted time series analysis was performed using annual data on BD rates, and the impact of the 400 ml BD program was investigated. RESULTS In a raw series, autoregressive integrated moving average analysis revealed a significant change in slope between the pre- and post-intervention periods in which the intervention factor was the 400 ml BD program. The parameters were as follows: intercept (initial value) = 0.315, confidence interval (CI) = (0.029, 0.601); slope (pre-intervention) = 0.316, CI = (0.293, 0.340); slope difference = -0.435, CI = (-0.462, -0.408); slope (post-intervention) = -0.119, CI = (-0.135, -0.103); all, p = 0.000; goodness-of-fit, R2 = 0.963. After adjusting for stationarity and autocorrelation, the parameters were as follows: intercept (initial value) = -0.699, CI = (-0.838, -0.560); slope (pre-intervention) = 0.136, CI = (0.085, 0.187); slope difference = -0.165, CI = (-0.247, -0.083); slope (post-intervention) = -0.029, CI = (-0.070, 0.012); all, p = 0.000 (except for slope (post-intervention), p = 0.170); goodness-of-fit, R2 = 0.930. CONCLUSION One of the causes for decrease in BD rates may be due to the introduction of the 400 ml BD program in Japan.
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Affiliation(s)
| | - Nobuyuki Miyatake
- Department of Hygiene, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan
| | - Hiromi Suzuki
- Department of Hygiene, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan
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