Key result
A safety-orientated system for delivering parenteral anaesthetic drugs reduced drug errors compared to conventional methods (0.032% vs 0.049%; absolute difference 0.017%, 95% CI 0.006-0.028%; p=0.002).
Why the study?
Does a new safety-orientated system of delivering parenteral anaesthetic drugs reduce parenteral drug errors during anaesthesia?
Cohort (n=74,478)
Yes
Does a new safety-orientated system of delivering parenteral anaesthetic drugs reduce parenteral drug errors during anaesthesia?
Absolute Risk Reduction: 0.017 (95% CI 0.006–0.028)
Absolute Event Rate: 0.032% vs 0.049%
Absolute Risk Reduction: 0.017%
p-value: p=0.002
A targeted safety-orientated system for delivering parenteral anaesthetic drugs significantly reduces medical errors compared to conventional methods.
May reduce drug errors in anaesthesia; hypothesis-generating and requires randomized confirmation before practice change.
A safety-orientated system of delivering parenteral anaesthetic drugs was assessed in a prospective incident monitoring study at two hospitals. Anaesthetists completed an incident form for every anaesthetic, indicating if an incident occurred. Case mix data were collected and the number of drug administrations made during procedures estimated. From February 1998 at Hospital A and from June 1999 at Hospital B, until November 2003, 74,478 anaesthetics were included, for which 59,273 incident forms were returned (a 79.6% response rate). Fewer parenteral drug errors occurred with the new system than with conventional methods (58 errors in an estimated 183,852 drug administrations (0.032%, 95% CI 0.024-0.041%) vs 268 in 550,105 (0.049%, 95% CI 0.043-0.055%) respectively, p = 0.002), a relative reduction of 35% (difference 0.017%, 95% CI 0.006-0.028%). No major adverse outcomes from these errors were reported with the new system while 11 (0.002%) were reported with conventional methods (p = 0.055). We conclude that targeted system re-design can reduce medical error.
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Webster et al. (2010) conducted a cohort in Patients undergoing anaesthesia (n=74,478). Safety-orientated system of delivering parenteral anaesthetic drugs vs. Conventional methods was evaluated on Parenteral drug errors (difference 0.017%, 95% CI 0.006-0.028, p=0.002). A safety-orientated system for delivering parenteral anaesthetic drugs reduced drug errors compared to conventional methods (0.032% vs 0.049%; absolute difference 0.017%, 95% CI 0.006-0.028%; p=0.002).
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