重症监护病房用药安全改进政策建议的制定和优先排序:欧洲医院药剂师协会特别兴趣小组德尔菲研究

Moninne Howlett, Suzanne McCarthy, Virginia Silvari, Bryony Dean Franklin, Raisa Laaksonen
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引用次数: 0

摘要

目标 用药错误(ME)是医疗系统中发病率和死亡率的主要原因。入住重症监护病房(ICU)的患者由于病情严重、接受的治疗复杂以及重症监护病房环境的挑战性,更容易发生用药错误。欧洲医院药剂师协会成立了一个特别兴趣小组 (SIG),负责开展一项工作计划,制定并优先考虑相关建议,以支持改善全欧洲 ICU 的用药安全。方法 在查阅文献并与相关利益方接触后,制定了 ICU 环境中用药安全的初步政策建议。2022 年,我们召集了一个由 21 名专家小组成员组成的德尔菲小组,该小组由具有 ICU 和/或用药安全专业知识的医护人员 (HCP) 组成。我们采用改良的德尔菲技术进行了两轮讨论,根据政策建议的实施优先级,参与者以匿名方式在 9 点李克特量表上对政策建议进行排序。结果 共制定了 32 项政策建议。在德尔菲第一轮中,有 19 名保健医生参加;对大多数建议达成了共识,对 6 项建议达成了部分共识。在德尔菲第二轮中,有 18 名高级专业人员参与。经过两轮德尔菲讨论,就所有 32 项建议达成了共识。除一项建议被视为 "中等优先 "外,其他所有建议均被视为 "高度优先"。结论 通过这项研究,我们有可能制定以证据为基础的政策建议,并确定其优先次序,以加强用药安全,这可能有助于减少欧洲各地重症监护病房的 MEs。除一项建议外,其他所有建议均被视为 "高优先级 "实施,这表明这些建议在通过预防重症监护病房 MEs 来提高用药安全方面具有重要价值。如有合理要求,可提供相关数据
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Development and prioritisation of policy recommendations for medication safety improvement for intensive care units: a European Association of Hospital Pharmacists Special Interest Group Delphi Study
Objectives Medication errors (MEs) are a leading cause of morbidity and mortality in the healthcare system. Patients admitted to intensive care units (ICUs) are potentially more susceptible to MEs due to severity of illness, the complexity of treatments they receive and the challenging nature of the ICU setting. The European Association of Hospital Pharmacists established a Special Interest Group (SIG) to undertake a programme of work to develop and prioritise recommendations to support medication safety improvement in ICUs across Europe. Methods Initial policy recommendations for medication safety within the ICU environment were developed following reviews of the literature and engagement with relevant stakeholders. A Delphi panel of 21 members of the SIG, that comprised healthcare professionals (HCPs) with expertise in ICU and/or medication safety, was convened in 2022. We conducted two rounds using a modified Delphi technique whereby participants anonymously ranked on a 9-point Likert Scale the policy recommendations according to their priority for implementation. Results In total, 32 policy recommendations were developed. In Delphi Round 1, 19 HCPs participated; consensus was achieved on most recommendations and partial consensus on six. In Delphi Round 2, 18 HCPs participated. After two Delphi rounds, consensus was achieved on all 32 recommendations. All recommendations were considered ‘high priority’ except one that was considered ‘medium priority’. Conclusions Through this study it was possible to develop and prioritise evidence-based policy recommendations to enhance medication safety, which may contribute to reducing MEs in ICUs across Europe. All recommendations were considered ‘high priority’ for implementation except one, indicating the perceived value of these recommendations in improving medication safety through preventing MEs in ICUs. Data are available upon reasonable request
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