Interception of potential adverse drug events in long-term psychiatric care units.
The interception of medication errors is required for patient safety. The aim of the present study was to clarify factors associated with the interception of potential adverse drug events in long-term psychiatric care units. A survey was conducted of medication-related errors in 132 Japanese long-term psychiatric care units for 2 months using an incident reporting system. The relationship was analyzed between the reported potential adverse drug events and the characteristics of the units and the staff, as well as those of the patients involved. A multivariate logistic regression analysis was performed with environmental, organizational, and human factors as independent variables to predict the interception of potential adverse drug events. Of the 221 reported incidents, 55 (24.9%) were intercepted before reaching patients. The following patient groups were significantly associated with the failure to intercept potential adverse drug events: patients receiving a relatively large number of tablets, patients with relatively frequent admissions, and patients exposed to a relatively high patient-staff ratio in the evening. In contrast, patients with a diagnosis of schizophrenia were significantly associated with an increased possibility of interception. To intercept more potential adverse drug events, simpler prescriptions are crucial. To improve the current situation, organizational efforts, such as increasing staff in the evening, and educating the staff about medications, will be required, as well as improvements in the medications themselves.
Sawamura
Kanae
K
Musashi Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan. sawa-tky@umin.ac.jp
Ito
Hiroto
H
Yamazumi
Syun
S
Kurita
Hiroshi
H
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003625:Data Collection; D011307:Drug Prescriptions / Q000592:standards; D005260:Female; D006801:Humans; D007564:Japan; D008134:Long-Term Care; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D001523:Mental Disorders / Q000188:drug therapy / Q000523:psychology; D008875:Middle Aged; D010349:Patient Compliance; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012308:Risk Management; D012559:Schizophrenia / Q000188:drug therapy
D014150:Antipsychotic Agents