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首页> 外文期刊>BMJ quality & safety >Increasing medication error reporting rates while reducing harm through simultaneous cultural and system-level interventions in an intensive care unit
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Increasing medication error reporting rates while reducing harm through simultaneous cultural and system-level interventions in an intensive care unit

机译：通过在重症监护室同时进行文化和系统级干预，提高用药错误报告率，同时减少伤害

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Objective: This study analyses patterns in reporting rates of medication errors, rates of medication errors with harm, and responses to the Safety Attitudes Questionnaire (SAQ), all in the context of four cultural and three system-level interventions for medication safety in an intensive care unit. Methods: Over a period of 2.5 years (May 2007 to November 2009), seven overlapping interventions to improve medication safety and reporting were implemented: a poster tracking 'days since last medication error resulting in harm', a continuous slideshow showing performance metrics in the staff lounge, multiple didactic curricula, unit-wide emails summarising medication errors, computerised physician order entry, introduction of unit-based pharmacy technicians for medication delivery, and patient safety report form streamlining. The reporting rate of medication errors and errors with harm were analysed over time using statistical process control. SAQ responses were collected annually. Results: Subsequent to the interventions, the reporting rate of medication errors increased 25%, from an average of 3.16 to 3.95 per 10 000 doses dispensed (p<0.09), while the rate of medication errors resulting in harm decreased 71%, from an average of 0.56 to 0.16 per 10 000 doses dispensed (p<0.01). The SAQ showed improvement in all 13 survey items related to medication safety, five of which were significant (p<0.05). Conclusion: Actively developing a transparent and positive safety culture at the unit level can improve medication safety. System-level mechanisms to promote medication safety are likely important factors that enable safety culture to translate into better outcomes, but may be independently ineffective in the face of poor safety culture.
机译：目的：本研究分析了在集中进行四种文化和三种系统级药物安全干预措施的背景下，报告药物错误率，具有伤害性的药物错误率以及对安全态度问卷（SAQ）的反应的模式。护理单位。方法：在2.5年的时间（2007年5月至2009年11月）中，实施了七项重叠的干预措施，以改善用药安全性和报告功能：张贴海报，跟踪“自上次用药错误导致伤害以来的天数”，连续幻灯片显示工作人员休息室，多个教学课程，汇总用药错误的单位范围电子邮件，计算机化的医生订单输入，介绍单位药物技术人员以进行药物输送以及简化患者安全报告表格。使用统计过程控制，随时间分析了药物错误和有伤害错误的报告率。每年都会收集SAQ响应。结果：干预后，每万剂给药的药物错误报告率从平均3.16升高到3.95（25％）（p <0.09），而导致伤害的药物错误率从71％下降了71％。每10000剂剂量平均0.56至0.16（p <0.01）。 SAQ在与药物安全性相关的所有13个调查项目中均显示出改善，其中五个显着（p <0.05）。结论：在单位一级积极建立透明和积极的安全文化可以提高药物安全性。促进药物安全的系统级机制可能是使安全文化转化为更好的结果的重要因素，但面对不良的安全文化却可能无效。

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