دورية أكاديمية
أعرض في EDS

Quality improvement programme reduces errors in oral medication preparation and administration through feeding tubes.

التفاصيل البيبلوغرافية
العنوان: Quality improvement programme reduces errors in oral medication preparation and administration through feeding tubes.
المؤلفون: Pereira RA; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil rosanna.pereira@gmail.com., de Souza FB; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil., Rigobello MCG; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil., Pereira JR; University of São Paulo Faculty of Economics Business and Accountancy of Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil., da Costa LRM; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil., Gimenes FRE; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil.
المصدر: BMJ open quality [BMJ Open Qual] 2020 Feb; Vol. 9 (1).
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101710381 Publication Model: Print Cited Medium: Internet ISSN: 2399-6641 (Electronic) Linking ISSN: 23996641 NLM ISO Abbreviation: BMJ Open Qual Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Publishing Group
مواضيع طبية MeSH: Administration, Oral* , Quality Improvement*, Enteral Nutrition/*standards , Medication Errors/*prevention & control, Brazil ; Enteral Nutrition/methods ; Enteral Nutrition/statistics & numerical data ; Humans
مستخلص: Background: Patients with nasogastric/nasoenteric tube (NGT/NET) are at increased risk of adverse outcomes due to errors occurring during oral medication preparation and administration.
Aim: To implement a quality improvement programme to reduce the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients.
Methods: An observational study was carried out, comparing outcome measures before and after implementation of the integrated quality programme to improve oral medication preparation and administration through NGT/NET. A collaborative approach based on Plan-Do-Study-Act (PDSA) cycle was used and feedback was given during multidisciplinary meetings.
Interventions: Good practice guidance for oral medication preparation and administration through NGT/NET was developed and implemented at the hospital sites; nurses were given formal training to use the good practice guidance; a printed list of oral medications that should never be crushed was provided to all members of the multidisciplinary team, and a printed table containing therapeutic alternatives for drugs that should never be crushed was provided to prescribers at the prescribing room.
Results: Improvement was observed in the following measures: crushing enteric-coated tablets and mixing drugs during medication preparation (from 54.9% in phase I to 26.2% in phase II; p 0.0010) and triturating pharmaceutical form of modified action or dragee (from 32.8 in phase I to 19.7 in phase II; p 0.0010). Worsening was observed though in the following measures: crush compressed to a fine and homogeneous powder (from 7.4%% in phase I to 95% phase II; p 0.0010) and feeding tube obstruction (from 41.8% in phase I to 52.5% phase II; p 0.0950).
Conclusion: Our results highlight how a collaborative quality improvement approach based on PDSA cycles can meet the challenge of reducing the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients. Some changes may lead to unintended consequences though. Thus, continuous monitoring for these consequences will help caregivers to prevent poor patient outcomes.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: PDSA; medication safety; quality improvement
تواريخ الأحداث: Date Created: 20200221 Date Completed: 20201030 Latest Revision: 20240328
رمز التحديث: 20240329
مُعرف محوري في PubMed: PMC7047508
DOI: 10.1136/bmjoq-2019-000882
PMID: 32075805
قاعدة البيانات: MEDLINE
الوصف
تدمد:2399-6641
DOI:10.1136/bmjoq-2019-000882