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Improving feedback on junior doctors’ prescribing errors: mixed methods evaluation of a quality improvement project

机译:改善初级医生处方错误的反馈:质量改进项目的混合方法评估

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摘要

Background Prescribing errors occur in up to 15% of UK inpatient medication orders. However, junior doctors report insufficient feedback on errors. A barrier preventing feedback is that individual prescribers often cannot be clearly identified on prescribing documentation. Aim To reduce prescribing errors in a UK hospital by improving feedback on prescribing errors. Interventions We developed three linked interventions using plan*do*study*act cycles: (1) name*stamps for junior doctors who were encouraged to stamp or write their name clearly when prescribing; (2) principles of effective feedback to support pharmacists to feed back to doctors on individual prescribing errors; (3) fortnightly prescribing advice emails that addressed a common and/or serious error. Implementation and evaluation Interventions were introduced at one hospital site in August 2013 with a second acting as control. Process measures included the percentage of inpatient medication orders for which junior doctor s stated their name. Outcome measures were junior doctors’ and pharmacists’ perceptions of current feedback provision (evaluated using quantitative pre*post questionnaires and qualitative focus groups), and the prevalence of erroneous medication orders written by junior doctors between August and December 2013.
机译:背景处方错误发生在多达15%的英国住院药物订购中。但是,初级医生报告对错误的反馈不足。防止反馈的障碍是,在处方文档中常常无法清楚地识别出各个处方者。目的通过改善对处方错误的反馈来减少英国医院的处方错误。干预措施我们使用计划*做*研究*行动周期开发了三种相关的干预措施:(1)初级医生的姓名*盖章,鼓励他们在开处方时加盖姓名或清楚地写上姓名; (2)有效反馈的原则,以支持药剂师就个别处方错误向医生反馈; (3)每两周开一次针对常见和/或严重错误的建议电子邮件。实施和评估干预措施于2013年8月在一个医院现场引入,第二个作为对照。处理措施包括初级医生说出姓名的住院用药单的百分比。结果指标包括初级医生和药剂师对当前反馈提供情况的看法(使用定量的事前/事后问卷调查和定性焦点小组进行评估),以及初级医生在2013年8月至2013年12月间写错药物处方的情况。

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