A study on the medication errors in the administration of N-acetylcysteine for paracetamol overdose patients in Malaysia

被引:9
作者
Au, V. [1 ]
Zakaria, M. I. [2 ]
机构
[1] RIPAS Hosp, Dept Accid & Emergency, Bandar Seri Begawan, Brunei
[2] JI Univ, Fac Med, Trauma & Emergency Unit, Kuala Lumpur 59100, Malaysia
关键词
Human; overdose; patient safety; risk management; ACETAMINOPHEN;
D O I
10.1177/102490791402100604
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: N-Acetylcysteine (NAC) has been used to treat paracetamol overdose for four decades. But the administration of NAC regimens is complicated. Therefore, medication errors are an ongoing issue in the acute-care setting and directly impact the safety of patients. Objective: To evaluate the rate of NAC-related medication errors during the management of paracetamol overdose at a teaching hospital in Malaysia. Methods: This clinical audit study was performed retrospectively between June 2008 and June 2011. Patients who presented to the adult emergency department with paracetamol overdose and had received at least the loading dose of intravenous NAC were eligible. Children below the age of 12 years old were not included. Also, patients displaying chronic excessive paracetamol usage or recurrent paracetamol overdose were excluded. We determined the type and frequency of medication errors during intravenous NAC administration. Results: The study population ranged from 13 to 87 years old (mean age: 25.06; median: 23) and was predominantly female. The overall prevalence of intravenous NAC-related medication errors was found to be 84.3%. Moreover, the following frequencies were observed based on error type: 5.9% wrong dose, 37.3% incorrect infusion rate, 8.5% interruption during treatment, and 66.5% unnecessary administration. Conclusion: We observe a surprisingly high prevalence of medication errors related to the administration of intravenous NAC. Thus, this emerging issue needs be addressed in order to ensure patient safety as well as to prevent unnecessary hospital admissions and/or burdening treatment costs.
引用
收藏
页码:361 / 367
页数:7
相关论文
共 18 条
[1]  
Atcha Z, 2000, HLTH STAT Q, V7, P5
[2]  
Bateman DN, 2007, J ROY COLL PHYS EDIN, V37, P331
[3]   Liver unit admission following paracetamol overdose with concentrations below current UK treatment thresholds [J].
Beer, C. ;
Pakravan, N. ;
Hudson, M. ;
Smith, L. T. ;
Simpson, K. ;
Bateman, D. N. ;
Thomas, S. H. L. .
QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, 2007, 100 (02) :93-96
[4]   Patient-tailored acetylcysteine administration [J].
Dart, Richard C. ;
Rumack, Barry H. .
ANNALS OF EMERGENCY MEDICINE, 2007, 50 (03) :280-281
[5]   Fatal myocardial infarction associated with intravenous N-acetylcysteine error [J].
Elms A.R. ;
Owen K.P. ;
Albertson T.E. ;
Sutter M.E. .
International Journal of Emergency Medicine, 4 (1)
[6]  
Fernando W. K. B. Kasun, 2009, CEYLON MEDICAL JOURNAL, V54, P16
[7]   Frequency of medication errors with intravenous acetylcysteine for acetaminophen overdose [J].
Hayes, Bryan D. ;
Klein-Schwartz, Wendy ;
Doyon, Suzanne .
ANNALS OF PHARMACOTHERAPY, 2008, 42 (06) :766-770
[8]   Management of paracetamol overdose - Current controversies [J].
Kozer, E ;
Koren, G .
DRUG SAFETY, 2001, 24 (07) :503-512
[9]   Acetaminophen and the US Acute Liver Failure Study Group: Lowering the risks of hepatic failure [J].
Lee, WM .
HEPATOLOGY, 2004, 40 (01) :6-9
[10]   Medical progress: Drug-induced hepatotoxicity [J].
Lee, WM .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (05) :474-485