Appl Clin Inform - Medication safety improves after implementation of positive patient identification.

Tópicos

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Resumo

JECTIVE: To report the incidence and severity of medication safety events before and after initiation of barcode scanning for positive patient identification (PPID) in a large teaching hospital.METHODS: Retrospective analysis of data from an existing safety reporting system with anonymous and non-punitive self-reporting. Medication safety events were categorized as "near-miss" (unsafe conditions or caught before reaching the patient) or reaching the patient, with requisite additional monitoring or treatment. Baseline and post-PPID implementation data on events per 1,000,000 drug administrations were compared by chi-square with p<0.05 considered significant.RESULTS: An average of 510,541 doses were dispensed each month in 2008. Total self-reported medication errors initially increased from 20 per million doses dispensed pre-barcoding (first quarter 2008) to 38 per million doses dispensed immediately post-intervention (last quarter 2008), but errors reaching the patient decreased from 3.26 per million to 0.8 per million despite the increase in "near-misses". A number of process issues were identified and improved, including additional training and equipment, instituting ParX scanning when filling Pyxis machines, and lobbying for a manufacturing change in how bar codes were printed on bags of intravenous solutions to reduce scanning failures.CONCLUSION: Introduction of barcoding of medications and patient wristbands reduced serious medication dispensing errors reaching the patient, but temporarily increased the number of "near-miss" situations reported. Overall patient safety improved with the barcoding and positive patient identification initiative. These results have been sustained during the 18 months following full implementation.

Resumo Limpo

jectiv report incid sever medic safeti event initi barcod scan posit patient identif ppid larg teach hospitalmethod retrospect analysi data exist safeti report system anonym nonpunit selfreport medic safeti event categor nearmiss unsaf condit caught reach patient reach patient requisit addit monitor treatment baselin postppid implement data event per drug administr compar chisquar p consid significantresult averag dose dispens month total selfreport medic error initi increas per million dose dispens prebarcod first quarter per million dose dispens immedi postintervent last quarter error reach patient decreas per million per million despit increas nearmiss number process issu identifi improv includ addit train equip institut parx scan fill pyxi machin lobbi manufactur chang bar code print bag intraven solut reduc scan failuresconclus introduct barcod medic patient wristband reduc serious medic dispens error reach patient temporarili increas number nearmiss situat report overal patient safeti improv barcod posit patient identif initi result sustain month follow full implement

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