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Medication-related patient harm in New Zealand hospitals.

Abstract The purpose of this study is to identify patterns of medication-related harm from a national perspective, and to use this information to inform decisions on where to focus medication safety efforts. This study updates a 2013 study using the same methodology.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the new zealand medical journal
Publication Year Start




PMID- 28796769
OWN - NLM
STAT- In-Process
DA  - 20170810
LR  - 20170810
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 130
IP  - 1460
DP  - 2017 Aug 11
TI  - Medication-related patient harm in New Zealand hospitals.
PG  - 21-32
AB  - AIM: The purpose of this study is to identify patterns of medication-related harm
      from a national perspective, and to use this information to inform decisions on
      where to focus medication safety efforts. This study updates a 2013 study using
      the same methodology. METHOD: District health boards (DHBs) still actively using 
      either the Adverse Drug Event (ADE) Trigger Tool (TT) or the Global Trigger Tool 
      (GTT), submitted two years of anonymised ADE data (1 July 2013-30 June 2015) to
      the Health Quality & Safety Commission (the Commission) using a standard
      template. Analyses were conducted using aggregated data only. RESULTS: Of eight
      DHBs who submitted data, six datasets were included, representing a total of
      2,659 chart reviews. From these reviews, 923 harms were identified in 751
      patients, with 28% of patients experiencing one or more harms. Harms occurred at 
      a rate of 34.7 per 100 admissions, 42.5 per 1,000 bed days and 28% of patients
      experienced one or more medication-related harms. Those harmed were more likely
      to be older, female and have an increased length of stay. Most harms (65%)
      occurred during an inpatient stay, however, a substantial number (29%) originated
      in the community and precipitated an admission. Across all levels of severity,
      the most common types of medication harm were constipation, hypotension and
      bleeding. In the more serious harm categories, bleeding, hypotension and
      delirium/confusion/over-sedation were most common. Six groups of medicines caused
      the greatest amount of harm: opioids (including tramadol),
      anticoagulants/antiplatelet agents, antibiotics, antianginals (beta-blockers,
      nitrates, calcium channel blockers and others), diuretics and other
      cardiovascular medicines (angiotensin-converting enzyme (ACE) inhibitors,
      angiotensin II receptor antagonists (ARBs), centrally acting agents and statins).
      Opioids and anticoagulants/antiplatelet agents not only accounted for 40% of all 
      harm, they were implicated in the most severe harm. CONCLUSION: This paper
      confirms earlier work that medication-related harms are common, occur both in
      hospitals and in the community, and are a substantial burden for patients and our
      healthcare system. Work is underway at local and national levels to decrease this
      harm, with a focus on the high-risk medicines most commonly implicated.
FAU - Robb, Gillian
AU  - Robb G
AD  - Senior Advisor, Health Quality & Safety Commission, Wellington, Professional
      Teaching Fellow, University of Auckland.
FAU - Loe, Elizabeth
AU  - Loe E
AD  - Medication Safety Specialist, Health Quality & Safety Commission, Wellington.
FAU - Maharaj, Ashika
AU  - Maharaj A
AD  - Teaching Associate, Department of Epidemiology and Preventive Medicine, School of
      Public Health and Preventive Medicine, Monash University, Melbourne, Victoria,
      Australia.
FAU - Hamblin, Richard
AU  - Hamblin R
AD  - Director, Health Quality Intelligence, Health Quality & Safety Commission,
      Wellington.
FAU - Seddon, Mary E
AU  - Seddon ME
AD  - Executive Director of Medical Services, West Moreton Hospital and Health
      Services, Queensland, Australia.
LA  - eng
PT  - Journal Article
DEP - 20170811
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
COI - Nil.
EDAT- 2017/08/11 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/08/11 06:00
PST - epublish
SO  - N Z Med J. 2017 Aug 11;130(1460):21-32.