Factors contributing to reported medication administration incidents in patients' homes - A text mining analysis.

To describe the characteristics of medication administration (MA) incidents reported to have occurred in patients' own homes (reporters' profession, incident types, contributing factors, patient consequence, and most common medications involved) and to identify the connection terms related to the most common contributing factors based on free text descriptions. A retrospective study using descriptive statistical analysis and text mining. Medication administration incidents (N = 19,725) reported to have occurred in patients' homes between 2013-2018 in one district in Finland were analysed, describing the data by the reporters' occupation, incident type, contributing factors, and patient consequence. SAS® Text Miner was used to analyse free text descriptions of the MA incidents to understand contributing factors, using concept linking. Most MA incidents were reported by practical (lower level) nurses (77.8%, N = 15,349). The most common category of harm was 'mild harm' (40.1%, N = 7,915) and the most common error type was omissions of drug doses (47.4%, N = 9,343). The medications most commonly described were Marevan [warfarin] (N = 2,668), insulin (N = 811), Furesis [furosemide] (N = 590), antibiotic (N = 446), and Panadol [paracetamol] (N = 416). The contributing factors most commonly reported were 'communication and flow of information' (25.5%, N = 5,038), 'patient and relatives' (22.6%, N = 4,451), 'practices' (9.9%, N = 1,959), 'education and training' (4.8%, N = 949), and 'work environment and resources' (3.0%, N = 598). There is need for effective communication and clear responsibilities between home care patients and their relatives and health providers, about MA and its challenges in home environments. Knowledge and skills relating to safe MA are also essential. These findings about MA incidents that have occurred in patients' homes and have been reported by home care professionals demonstrate the need for medication safety improvement in home care. 目的: 描述所报道患者家中用药事件(MA)事件的特征(报道者的职业、事件类型、影响因素、患者后果以及所涉及的最常见药物),并通过自由文本确定与最常见的影响因素相关的连接项。 设计: 使用描述性统计分析和文本挖掘方法,进行回顾性研究。 方法: 2013年至2018年间,芬兰境内某一地区发生多起患者家中用药事件(N = 19,725),现已对这些事件进行分析,按报道者的职业、事件类型、影响因素和患者后果等对相关数据进行描述说明。利用SAS®Text Miner,对患者家中用药事件的自由文本描述进行分析,从而了解影响因素,并使用相关概念链接。 结果: 大多数患者家中用药事件都是由实习(低级)护士报道(77.8%,N=15,349)。最常见的伤害类别是“轻度伤害”(40.1%,N=7915),且最常见的错误类型是药物剂量不足(47.4%,N=9343)。最常见的药物包括华法林钠片【华法林】(N=2668)、胰岛素(N=811)、Furesis【呋塞米】(N=590)、抗生素(N=446)和必理通【扑热息痛】(N=416)。最常见的影响因素包括“沟通和信息流”(25.5%,N=5038)、“患者和亲属”(22.6%,N=4451)、“实践”(9.9%,N=1959)、“教育和培训”(4.8%,N=949)以及“工作环境和资源”(3.0%,N=598)。 结论: 有必要确保家庭护理患者、其亲属和健康提供者之间的有效沟通,明确各方责任,了解患者家中用药事件及其可能对家庭环境带来的挑战。此外,应该学习与患者家中安全用药相关的知识和技能。 影响: 这些调查结果与患者家中用药事件相关,由专业家庭护理人员报告,可证明在家庭护理中提高药物安全性的必要性。.

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