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Preventable drug-related incidens of hemorrhage in nursing homes. A retrospective, descriptive research on preventable incidents of hemorrhage related to anticoagulation, antiplatelet NSAID's use.

Striebeek, Sulaine (2013) Preventable drug-related incidens of hemorrhage in nursing homes. A retrospective, descriptive research on preventable incidents of hemorrhage related to anticoagulation, antiplatelet NSAID's use.

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Abstract:Background: Patient safety, especially medication safety, is one of the main concerns in healthcare. Studies have pointed out a relationship between preventable drug-related ADR such as hemorrhages and the use of anticoagulation, antiplatelet and NSAID’s. Conclusive information concerning the occurrence rate of preventable drug-related incidents of hemorrhage related to the use of these medications in nursing home is scarce. Objective: To identify the prescription rate of anticoagulation, antiplatelet, NSAID’s and combination of two or more of the drugs mentioned and to observe the occurrences of preventable drug related hemorrhage among nursing home residents using anticoagulation, antiplatelet and NSAID’s. Method: A retrospective, descriptive study was carried out among the residents of the 18 nursing homes of Carintreggeland living in the nursing homes in the period of January 2011 till April 2013. Medical records of 608 patients were reviewed for potential preventable drug-related incidents of hemorrhage. The collected data were summarized and placed in a MRF. Preventable drug-related incidents of hemorrhage were assessed using an adjusted version of the algorithm of Kramer et al. The severity of the harm was assessed using the NCC MERP Index for Categorizing Medication Errors and the NCC MERP Index for Categorizing Medication Errors Algorithm. Results: The prescription rate of anticoagulation, antiplatelet, NSAID’s and combination of two or more of these drugs were 33 per 100 patient years. The most prescribed drug was antiplatelet. The anticoagulation, antiplatelet and NSAID users had a total of 180 incidents of hemorrhage of which four were preventable. The nonusers had a total of 56 incidents of hemorrhage. The category of harm detected were circumstances or events that have the capacity to cause error; an error occurred that reached the patient but did not cause patient harm; an error occurred that reached the patient and required monitoring to confirm that it resulted in no harm to the patient and/or required intervention to preclude harm. The preventable drug-related hemorrhages resulted in prolonged bleeding and temporary injury. Conclusion: Anticoagulation, antiplatelet and NSAID users had a 1.9 fold greater risk on experiencing hemorrhage than nonusers. However, the incident rate of preventable drug-related hemorrhages in the nursing home is low. A total of four preventable incidents of hemorrhage were detected.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:88 social and public administration
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/64524
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