Prospective, controlled study of an intervention to reduce errors in neonatal antibiotic orders
| Autor: | Sandra S. Garner, Elizabeth G. Hill, Robin L. Bissinger, David J. Annibale, M G Irving, Toby H Cox |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Pediatrics medicine.drug_class Antibiotics MEDLINE Drug Prescriptions Late Onset Disorders Intensive Care Units Neonatal Sepsis Intervention (counseling) medicine Humans Medication Errors Maternal fetal Prospective Studies Neonatology Prospective cohort study business.industry Infant Newborn Infant Obstetrics and Gynecology Gestational age Anti-Bacterial Agents Practice Guidelines as Topic Pediatrics Perinatology and Child Health business |
| Zdroj: | Journal of Perinatology. 35:631-635 |
| ISSN: | 1476-5543 0743-8346 |
| Popis: | To evaluate the effectiveness of an interactive computerized order set with decision support (ICOS-DS) in preventing medication errors in neonatal late-onset sepsis (LOS).Prospective, controlled comparison of error rates in antibiotic orders for neonates admitted to the Medical University of South Carolina neonatal intensive care unit with suspected LOS (after postnatal day of life 3) prior to (n=153) and after (n=146) implementation of the ICOS-DS. Antibiotic orders were independently evaluated by two pharmacists for prescribing errors, potential errors and omissions. Prescribing errors included10% overdoses or underdoses, inappropriate route, schedule or antibiotic, drug-drug or drug-disease interactions, and incorrect patient demographics. Potential errors included misspelled drugs, leading decimals, trailing zeroes, impractical doses and error-prone abbreviations. Multiple errors and omissions in an order were counted individually.Overall error rate per order decreased from 1.7 to 0.8 (P0.001) and potential error rate from 1.0 to 0.06 (P0.001). The reduction in omission error rate per order from 0.2 to 0.1 was not significant (P=0.17). The prescribing error rate per order increased from 0.4 to 0.7 (P=0.03) because of the use of incorrect patient weights (P0.001). Renal dysfunction was significantly associated with an increased risk of prescribing errors (odds ratio=3.7, P=0.01) which was not significantly different for handwritten versus ICOS-DS orders (P=0.15).The ICOS-DS significantly improved the quality of neonatal LOS antibiotic orders although the use of incorrect patient weights was increased. In both groups, orders for patients with renal dysfunction were at risk for prescribing errors. Further evaluation of interventions to promote medication safety for this population is needed. |
| Databáze: | OpenAIRE |
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