title: Streamlining the medication process improves safety in the intensive care unit.
abstract: BACKGROUND
  Multiple interventions were made to optimize the medication process in our intensive care unit (ICU). 1 Transcriptions from the medical order form to the administration plan were eliminated by merging both into a single document; 2 the new form was built in a logical sequence and was highly structured to promote completeness and standardization of information; 3 frequently used drug names, approved units, and fixed routes were pre-printed; 4 physicians and nurses were trained with regard to the correct use of the new form. This study was aimed at evaluating the impact of these interventions on clinically significant types of medication errors.
  
  
  METHODS
  Eight types of medication errors were measured by a prospective chart review before and after the interventions in the ICU of a public tertiary care hospital. We used an interrupted time-series design to control the secular trends.
  
  
  RESULTS
  Over 85 days, 9298 lines of drug prescription and/or administration to 294 patients, corresponding to 754 patient-days were collected and analysed for the three series before and three series following the intervention. Global error rate decreased from 4.95 to 2.14% (-56.8%, P < 0.001).
  
  
  CONCLUSIONS
  The safety of the medication process in our ICU was improved by simple and inexpensive interventions. In addition to the optimization of the prescription writing process, the documentation of intravenous preparation, and the scheduling of administration, the elimination of the transcription in combination with the training of users contributed to reducing errors and carried an interesting potential to increase safety.
authors.affiliation: Department of Pharmacy, Institut Central des Hôpitaux Valaisans, Sion, Switzerland. emmanuel.benoit@hopitalvs.ch
authors.forename: E
authors.initials: E
authors.lastname: Benoit
authors.forename: P
authors.initials: P
authors.lastname: Eckert
authors.forename: C
authors.initials: C
authors.lastname: Theytaz
authors.forename: M
authors.initials: M
authors.lastname: Joris-Frasseren
authors.forename: M
authors.initials: M
authors.lastname: Faouzi
authors.forename: J
authors.initials: J
authors.lastname: Beney
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods* / Q000458:organization & administration*; D004282:Documentation; D011307:Drug Prescriptions / Q000592:standards; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D016015:Logistic Models; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D008875:Middle Aged; D009726:Nurses; D061214:Patient Safety; D004364:Pharmaceutical Preparations / Q000008:administration & dosage; D013557:Switzerland; D062606:Tertiary Care Centers
chemical_list: D004364:Pharmaceutical Preparations