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首页> 外文期刊>The American journal of geriatric pharmacotherapy >Repeat medication errors in nursing homes: Contributing factors and their association with patient harm.
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Repeat medication errors in nursing homes: Contributing factors and their association with patient harm.

机译：在疗养院中重复用药错误：影响因素及其与患者伤害的关系。

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BACKGROUND: Medication errors are highly prevalent in long-term care facilities and are responsible for preventable injury. Repeat medication errors, or identical events occurring multiple times in the same patient, may be particularly preventable. OBJECTIVES: This study assessed the factors that contribute to repeat medication errors and the association between repeat medication errors and patient harm. METHODS: In this cross-sectional analysis, medication error reports submitted by licensed nursing homes to North Carolina's Medication Error Quality Initiative-Individual Error Web-based incident reporting system were analyzed for fiscal years 2006-2008. When reporting errors, the sites were asked whether the event was identically repeated within the same patient. Repeat medication errors were defined as identical events in terms of patient characteristics, drug involved, error type, potential cause, phase of the medication care process, and personnel involved. Repeat errors were compared with nonrepeat errors. Multivariate logistic regression was used to explore whether certain patient or error characteristics were related to a higher likelihood of repeat errors, and a similar analysis was used to explore whether repeat errors were related to patient harm. RESULTS: Of the total 15,037 errors reported by 294 unique nursing homes, 5615 (37.3%) were repeated one or more times. Among the repeat errors, the associated event within each error was repeated a mean (SD) of 10.7 (14.3) times. Wrong dosage (65.1% [3654/5615]) and wrong administration (10.2% [571/5615]) were the most frequent repeated events. In multivariate analysis, repeat errors occurred less frequently among younger residents (aged <75 years) than among older residents (aged >or=75 years) (odds ratio [OR] = 0.85; 95% CI, 0.79-0.93) and among residents able to direct their own care compared with cognitively impaired residents (OR = 0.87; 95% CI, 0.81-0.95). Patient harm was reported in only 1.2% (68/5615) of repeat errors and 0.6% (55/9422) of non-repeat errors. A multivariate analysis of patient harm found that repeat errors were more likely to be harmful than were nonrepeat errors (OR = 2.11; 95% CI, 1.43-3.11). CONCLUSIONS: Repeat medication errors in nursing homes are a common occurrence and have greater odds of being associated with harm than do nonrepeat errors. Future patient-safety research should focus on factors related to repeat errors.
机译：背景：用药错误在长期护理机构中非常普遍，并导致可预防的伤害。重复用药错误或同一患者多次发生相同事件可能是特别可预防的。目的：本研究评估了导致重复用药错误以及重复用药错误与患者伤害之间关系的因素。方法：在此横断面分析中，分析了2006-2008财政年度由许可的疗养院向北卡罗来纳州的药物错误质量计划-基于网络的个人错误事件报告系统提交的药物错误报告。报告错误时，询问站点是否在同一患者中重复了相同事件。重复用药错误是指根据患者特征，所用药物，错误类型，潜在原因，用药护理过程的阶段以及所涉及的人员而发生的相同事件。将重复错误与非重复错误进行比较。多变量logistic回归用于探讨某些患者或错误特征是否与重复错误的可能性更高有关，而类似的分析用于探讨重复错误是否与患者伤害有关。结果：在294家独特的疗养院报告的总15,037错误中，有5615件（37.3％）被重复了一次或多次。在重复错误中，每个错误内的关联事件重复的平均值（SD）为10.7（14.3）倍。错误的剂量（65.1％[3654/5615]）和错误的给药（10.2％[571/5615]）是最常见的重复事件。在多变量分析中，年轻居民（<75岁）的重复错误发生频率低于年长居民（>或= 75岁）（优势比[OR] = 0.85; 95％CI，0.79-0.93）和居民与有认知障碍的居民相比，他们有能力指导自己的护理（OR = 0.87; 95％CI，0.81-0.95）。仅1.2％（68/5615）的重复错误和0.6％（55/9422）的非重复错误报告了对患者的伤害。对患者伤害的多变量分析发现，重复错误比非重复错误更有可能造成危害（OR = 2.11; 95％CI，1.43-3.11）。结论：在疗养院中重复用药错误是一种常见现象，与不可重复性错误相比，与伤害相关的可能性更大。未来的患者安全研究应关注与重复错误相关的因素。

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