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首页> 外文期刊>BMJ quality & safety >Effectiveness of double checking to reduce medication administration errors: a systematic review
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Effectiveness of double checking to reduce medication administration errors: a systematic review

机译：双重检查减少药物管理误差的有效性：系统评价

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Background Double checking medication administration in hospitals is often standard practice, particularly for high-risk drugs, yet its effectiveness in reducing medication administration errors (MAEs) and improving patient outcomes remains unclear. We conducted a systematic review of studies evaluating evidence of the effectiveness of double checking to reduce MAEs. Methods Five databases (PubMed, Embase, CINAHL, Ovid@Journals, OpenGrey) were searched for studies evaluating the use and effectiveness of double checking on reducing medication administration errors in a hospital setting. Included studies were required to report any of three outcome measures: an effect estimate such as a risk ratio or risk difference representing the association between double checking and MAEs, or between double checking and patient harm; or a rate representing adherence to the hospital's double checking policy. Results Thirteen studies were identified, including 10 studies using an observational study design, two randomised controlled trials and one randomised trial in a simulated setting. Studies included both paediatric and adult inpatient populations and varied considerably in quality. Among three good quality studies, only one showed a significant association between double checking and a reduction in MAEs, another showed no association, and the third study reported only adherence rates. No studies investigated changes in medication-related harm associated with double checking. Reported double checking adherence rates ranged from 52% to 97% of administrations. Only three studies reported if and how independent and primed double checking were differentiated. Conclusion There is insufficient evidence that double versus single checking of medication administration is associated with lower rates of MAEs or reduced harm. Most comparative studies fail to define or investigate the level of adherence to independent double checking, further limiting conclusions regarding effectiveness in error prevention. Higher-quality studies are needed to determine if, and in what context (eg, drug type, setting), double checking produces sufficient benefits in patient safety to warrant the considerable resources required. .
机译：背景技术医院中的双重检查药物管理通常是标准的做法，特别是对于高风险药物，其在减少药物管理误差（MAE）和改善患者结果方面的有效性仍不清楚。我们对研究进行了系统审查，评估了对减少MAES的双重检查有效性的证据。方法搜索五个数据库（PubMed，Embase，Cinahl，Ovid @期刊，OpenGrey），用于评估双重检查在医院环境中减少药物管理错误的使用和有效性。包括在三项结果措施中需要进行的研究：效果估计，例如代表双重检查和MAE之间的关联或双重检查和患者伤害之间的风险比或风险差异;或代表遵守医院的双重检查政策的速度。结果鉴定了13项研究，其中包括使用观察研究设计的10项研究，两个随机对照试验和模拟设置中的一个随机试验。研究包括儿科和成人住院人口，质量很大。在三项良好的质量研究中，只有一个人展示了双重检查和减少MAE的重大关联，另一个表现出没有关联，第三研究报告仅遵守率。没有研究调查与双重检查相关的药物相关危害的变化。报告的双重检查遵守率从52％到97％的主管部门。只有三项研究报告，如果是如何区分和自然和初步的双重检查。结论没有足够的证据表明，双重与单次检查药物管理局的证据与较低的MAES或危害降低有关。大多数比较研究未能定义或调查遵守独立双重检查的水平，进一步限制了预防误差有效性的结论。需要更高质量的研究来确定，以及在什么环境（例如，药物类型，设置）中，双重检查在患者安全中产生足够的益处，以保证所需的相当大的资源。 。

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