UNASSIGNED: Medication charts and electronic patient records of 54 patients before (cohort I) and 65 patients after (cohort II) CPOE implementation were reviewed retrospectively by a clinical pharmacist. All identified DRPs were collected and classified based on \'The PCNE Classification V9.1\', the German database DokuPIK, and the \'NCC MERP Taxonomy of Medication Errors\'.
UNASSIGNED: 325 DRPs were identified in 54 patients with a mean of 6 DRPs per patient and 151.9 DRPs per 1000 patient days in cohort I. In cohort II, 214 DRPs were identified in 65 patients with a mean of 3.3 DRPs per patient and 81.3 DRPs per 1000 patient days. The odds of having a DRP were significantly lower in cohort II (OR=0.545, 95% CI 0.412-0.721, p<0.001). The most frequent DRP in cohort I was an erroneous prescription (n=113, 34.8%), which was significantly reduced in cohort II (n=12, 5.6%, p<0.001). During the retrospective in-depth review, more DRPs were identified than during the daily plausibility analyses. At hospital discharge, patients had significantly less unsolved DRPs in cohort II than in cohort I.
UNASSIGNED: The implementation of a CPOE system with an integrated CDSS reduced the overall prevalence of DRPs, especially of prescription errors, and led to a smaller rate of unsolved DRPs in psychiatric inpatients at hospital discharge. Not all DRPs were found by plausibility analyses based on the medication charts. A more interactive and interdisciplinary patient-oriented approach might result in the resolution of more DRPs.
■临床药师回顾性审查了CPOE实施前(队列I)54例患者和实施后(队列II)65例患者的用药图表和电子病历。所有确定的DRP都是根据“PCNE分类V9.1”收集和分类的,德国数据库DokuPIK,和“NCCMERP药物错误分类法”。
■在54例患者中确定了325个DRPs,平均每个患者6个DRPs,在队列I中每1000个患者天151.9个DRPs,在65名患者中鉴定出214名DRP,平均每名患者3.3名DRP,每1000名患者天平均81.3名DRP。在队列II中,发生DRP的几率显着降低(OR=0.545,95%CI0.412-0.721,p<0.001)。队列I中最常见的DRP是错误的处方(n=113,34.8%),在队列II中显著降低(n=12,5.6%,p<0.001)。在回顾性深入审查期间,与每日合理性分析相比,发现的DRP更多.出院时,队列II患者的未解决DRPs明显少于队列I。
■实施具有集成CDSS的CPOE系统降低了DRPs的总体患病率,尤其是处方错误,并导致精神病住院患者出院时未解决的DRPs发生率较低。并非所有DRP都是通过基于药物图表的合理性分析找到的。一种更具互动性和跨学科的面向患者的方法可能会导致更多DRP的解决。