■及时的万古霉素治疗药物监测(TDM)可以迅速调整剂量和安全治疗。当地事件促使人们调查报告时间延长的原因。
■为了调查有和没有现场TDM处理的医院之间万古霉素浓度报告时间的变化,和患者安全问题。
■医院1的万古霉素浓度结果(非现场监测),对2021年6月至12月的2号和3号医院(均为现场监测)进行了回顾性分析。在现场TDM开始后3个月对医院重复回顾性数据收集以进行比较。对医院1的万古霉素临床事件进行了审查,以确定何时延迟报告结果可能导致患者不良结局的例子。
■与医院2和医院T3相比,医院1的中位报告时间为11.13h(分别为1.73h和1.70h)。在医院1开始现场TDM后,报告时间减少至1.33h(p<0.001)。在非现场监测期间,第一医院发生的几起事件涉及TDM结果的延迟。
■TDM的非现场处理导致万古霉素浓度报告明显延迟,通过过渡到现场测试的可用性,这一点得到了显着改善。这项研究还强调了准确的问题识别对提高患者安全性的影响。
UNASSIGNED: Timely vancomycin therapeutic drug monitoring (TDM) enables prompt dose adjustments and safe treatment. Local incidents prompted an investigation into the reasons for prolonged reporting times.
UNASSIGNED: To investigate the variation in reporting times of vancomycin concentrations between hospitals with and without on-site TDM processing, and patient safety implications.
UNASSIGNED: Vancomycin concentration results for Hospital 1 (off-site monitoring), Hospitals 2 and 3 (both on-site monitoring) from June to December 2021 were retrospectively analysed. Retrospective data collection was repeated for Hospital 1 three months post on-site TDM commencement for comparison. Vancomycin clinical incidents at Hospital 1 were reviewed to identify examples of when delays in reporting of results potentially contributed towards adverse patient outcomes.
UNASSIGNED: Hospital 1 had a median reporting time of 11.13 h compared with Hospital 2 and Hospital T3 (1.73 h and 1.70 h respectively). Following the commencement of on-site TDM at Hospital 1, the reporting time reduced to 1.33 h (p < 0.001). Several incidents at Hospital 1 during the period of off-site monitoring involved delays to TDM results.
UNASSIGNED: Off-site processing of TDM introduced significant delays in reporting of vancomycin concentrations, which was significantly improved by transitioning to onsite availability of testing. This study also highlights the impact of accurate problem identification in improving patient safety.