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Evaluation of the medication process of intravenous preparations in two intensive care units

Hermanspann, Theresa^RWTH*

2019

Verantwortlichkeitsangabevorgelegt von Theresa Hermanspann

ImpressumAachen 2019

Umfang1 Band (verschiedene Zählungen) : Illustrationen, Diagramme

Dissertation, Rheinisch-Westfälische Technische Hochschule Aachen, 2019, Kumulative Dissertation

Genehmigende Fakultät
Fak10

Hauptberichter/Gutachter
Orlikowsky, Thorsten (Thesis advisor)^RWTH* ; Stoppe, Christian (Thesis advisor)^RWTH*

Tag der mündlichen Prüfung/Habilitation
2019-09-18

Einrichtungen

1. Lehrstuhl für Allgemeine Pädiatrie (537500-2)

Thematische Einordnung (Klassifikation)
DDC: 610

Kurzfassung
Purpose: To determine the type, frequency, and factors associated with medication preparationand administration errors in adult intensive care units (ICUs) and neonatal ICUs (NICUs)/pediatric ICUs (PICUs).Patients and methods: We conducted a prospective direct observation study in an adultICU and NICU/PICU in a tertiary university hospital. Between June 2012 and June 2013, aclinical pharmacist and medical student observed the nursing care staff on weekdays duringthe preparation and administration of intravenous drugs. We analyzed the frequency and typeof preparation and administration errors and factors associated with errors.Results: Six hundred and three preparations in the adult ICU and 281 in the NICU/PICU wereobserved. Three hundred and eighty-five errors occurred in the adult ICU and 38 in the NICU/PICU. There were 5,040 and 2,514 error opportunities, with overall error rates of 7.6% and 1.5%,respectively. The total opportunities for error meant each single step of preparation and administrationthat was relevant for the drug. Most errors applied to the category “uniform mixing”(adult ICU: n=227, 59%; NICU/PICU: n=14, 37%). The multivariate logistic regression resultsshowed a significantly different influence of the “preparation type” for the adult ICU comparedwith the NICU/PICU with regard to the occurrence of an error. Preparations for adult patientsof the LCD type (liquid concentrate with diluent into syringe or infusion bag) were more oftenassociated with errors than the P (powder in a glass vial that must be reconstituted and dilutedif necessary), P=0.012, and LC (liquid concentrate into syringe), P=0.002 type.Conclusion: “Uniform mixing” was the most erroneous preparation step in intravenous drugpreparations in two ICUs. Improvement of nurse training and the preparation of prefilled syringesin the pharmacy might reduce errors and improve the quality and safety of drug therapy.

Dokumenttyp
Dissertation / PhD Thesis

Format
print

Sprache
English

Externe Identnummern
HBZ: HT020278137

Interne Identnummern
RWTH-2019-11105
Datensatz-ID: 773440

Beteiligte Länder
Germany