Clinical Decision Support System-Assisted Pharmacy Intervention Reduces Feeding Tube-Related Medication Errors in Hospitalized Patients: A Focus on Medication Suitable for Feeding-Tube Administration.

Autor: Wasylewicz ATM; Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands., van Grinsven RJB; Blixembosch Community Pharmacy, Eindhoven, the Netherlands., Bikker JMW; Outpatient Pharmacy, Erasmus Medical Centre, Rotterdam, the Netherlands., Korsten HHM; Department of Signal Processing Systems, Faculty of Electronic Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., Egberts TCG; Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands.; Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands., Kerskes CHM; Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands., Grouls RJE; Department of Clinical Pharmacy, Catharina Hospital, Eindhoven, the Netherlands.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Mar; Vol. 45 (3), pp. 625-632. Date of Electronic Publication: 2020 Jun 25.
DOI: 10.1002/jpen.1869
Abstrakt: Background: Administering medication through an enteral feeding tube (FT) is a frequent cause of errors resulting in increased morbidity and cost. Studies on interventions to prevent these errors in hospitalized patients, however, are limited.
Objective: The objective was to study the effect of a clinical decision support system (CDSS)-assisted pharmacy intervention on the incidence of FT-related medication errors (FTRMEs) in hospitalized patients.
Methods: A pre-post intervention study was conducted between October 2014 and May 2015 in Catharina Hospital, the Netherlands. Patients who were admitted to the wards of bowel and liver disease, oncology, or neurology; using oral medication; and had an enteral FT were included. Preintervention patients were given care as usual. The intervention consisted of implementing a CDSS-assisted pharmacy check while also implementing standard operating procedures and educating personnel. An FTRME was defined as the administration of inappropriate medication through an enteral FT. The incidence was expressed as the number of FTRMEs per medication administration. Multivariate Poisson regression was used to calculate the incidence ratio (IR) comparing both phases.
Results: Eighty-one patients were included, 38 during preintervention and 43 during the intervention phase. Incidence of FTRMEs in the preintervention phase was 0.15 (95% CI, 0.07-0.23) vs 0.02 (95% CI, 0.00-0.04) in the intervention phase, resulting in an adjusted IR of 0.13 (95% CI, 0.10-0.18).
Discussion: Incidence of FTRMEs, as well as the IR, is comparable to previous studies.
Conclusion: The intervention resulted in a substantial reduction in the incidence of FTRMEs.
(© 2020 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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