Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system

被引：22

作者：

Daupin, Johanne ^{[1
]}

Atkinson, Suzanne ^{[1
,2
]}

Bedard, Pascal ^{[1
,2
]}

Pelchat, Veronique ^{[3
]}

Lebel, Denis ^{[1
,2
]}

Bussieres, Jean-Francois ^{[1
,2
]}

机构：

[1] CHU St Justine, Pharm Practice Res Unit, 3175 Chemin Cote St Catherine, Montreal, PQ H3T 1C5, Canada

[2] CHU St Justine, Dept Pharm, 3175 Chemin Cote St Catherine, Montreal, PQ H3T 1C5, Canada

[3] CHU St Justine, Dept Nursing, Montreal, PQ, Canada

来源：

JOURNAL OF EVALUATION IN CLINICAL PRACTICE | 2016年 / 22卷 / 06期

关键词：

continuous quality improvement; medication error; medication-use system; patient safety; professional practice; simulation-based training; ADVERSE DRUG EVENTS; PEDIATRIC INPATIENTS; CONTROLLED-TRIAL; INTENSIVE-CARE; SERIOUS GAME; STUDENTS; HOSPITALS; EDUCATION; SAFETY;

D O I：

10.1111/jep.12558

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Rationale, aims and objectivesThe medication-use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication-use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system using a simulation. The secondary objective was to assess their level of satisfaction. MethodThis descriptive cross-sectional study was conducted in a 500-bed mother-and-child university hospital. A multidisciplinary group set up 30 situations and replicated a patient room and a care unit pharmacy. All hospital staff, including nurses, physicians, pharmacists and pharmacy technicians, was invited. Participants had to detect if a situation contained an error and fill out a response grid. They also answered a satisfaction survey. ResultsThe simulation was held during 100hours. A total of 230 professionals visited the simulation, 207 handed in a response grid and 136 answered the satisfaction survey. The participants' overall rate of correct answers was 67.5%13.3% (4073/6036). Among the least detected errors were situations involving a Y-site infusion incompatibility, an oral syringe preparation and the patient's identification. Participants mainly considered the simulation as effective in identifying incorrect practices (132/136, 97.8%) and relevant to their practice (129/136, 95.6%). Most of them (114/136; 84.4%) intended to change their practices in view of their exposure to the simulation. ConclusionsWe implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes.

引用

页码：907 / 916

页数：10