Implementation of targeted interventions to decrease antiretroviral-related errors in hospitalized patients.

Purpose. The implementation and effectiveness of targeted interventions aimed at decreasing the frequency of antiretroviralrelated errors in hospitalized patients with human immunodeficiency virus (HIV) are described. Summary. A prospective investigation conducted at the University of North Carolina...

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Published in:American Journal of Health-System Pharmacy Vol. 69; no. 5; pp. 422 - 431
Main Authors: Daniels, Lindsay M., Raasch, Ralph H., Corbett, Amanda H.
Format: research tables/charts teaching materials Journal Article
Published: Oxford University Press / USA 3/1/2012
Online Access:View this record in EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Implementation of targeted interventions to decrease antiretroviral-related errors in hospitalized patients.
      aug:
        au:
          Daniels, Lindsay M.
          Raasch, Ralph H.
          Corbett, Amanda H.
        affil: Clinical Pharmacy Specialist--Infectious Diseases, Department of Pharmacy, University of North Carolina Hospitals, Chapel Hill
      sug:
        subj:
          Anti-Retroviral Agents Adverse Effects
          Medication Errors Prevention and Control
          Anti-Retroviral Agents Administration and Dosage
          Teaching Materials, Clinical
          Anti-HIV Agents
          Pharmacy Service
          Formularies
          Clinical Pharmacy Information Systems
          Drug Resistance
          Electronic Order Entry
          Drug Interactions
          Program Implementation
          Medication Systems
          Pharmacists
          Root Cause Analysis
          Human
          Adult
          Middle Age
          Male
          Female
          Inpatients
          North Carolina
          Drug Combinations
          Academic Medical Centers
          Quality Assurance
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose. The implementation and effectiveness of targeted interventions aimed at decreasing the frequency of antiretroviralrelated errors in hospitalized patients with human immunodeficiency virus (HIV) are described. Summary. A prospective investigation conducted at the University of North Carolina Hospitals revealed a high rate of antiretroviral-related errors occurring on admission to the hospital and throughout a patient's hospital stay. The high frequency of errors emphasized the need for targeted interventions aimed at preventing these errors and quickly identifying and resolving errors that do occur. Several interventions aimed at decreasing this error rate were instituted, including the addition of computer alerts for incorrect doses and drug interactions to the pharmacy order-entry system, distribution of an educational pocket-sized card among the staff, addition of commercially available combination antiretroviral products to the hospital formulary, updates of the computerized prescriber-order-entry (CPOE) system to include common dosage defaults, involvement of the infectious diseases consultation service to evaluate prescribed regimens of newly admitted patients with HIV, and daily review of newly initiated antiretroviral regimens by a clinical pharmacist trained in HIV care. A follow-up analysis was conducted after these interventions were implemented to evaluate their effectiveness. Of the 78 patients identified during the postintervention analysis, 12 (15%) had at least one error in their initial drug regimen versus 49 patients (72%) in the preintervention study (p < 0.001). Conclusion. Antiretroviral medication error rates decreased after the implementation of targeted interventions that included distributing an educational pocket-sized card, adding alerts to the pharmacy order-entry system, incorporating default dosages into the CPOE system, and adding combination antiretrovirals to the formulary.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        teaching materials
        Journal Article
      ougenre: Article
    language: English
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