Enoxaparin dosing errors in the emergency department  

作　　者：Samantha P.Jellinek-Cohen May Li Gregg Husk 

机构地区：[1]College of Pharmacy and Health Sciences, St.John's University [2]The David B.Kriser Department of Emergency Medicine, Mount Sinai Beth Israel

出　　处：《World Journal of Emergency Medicine》2018年第3期195-202,共8页世界急诊医学杂志（英文）

摘　　要：BACKGROUND:The study aimed to determine the frequency of enoxaparin dosing errors for patients who had a measured emergency department(ED)weight compared to those who did not have a measured ED weight,and to determine if demographic variables(e.g.,weight,height,age,Englishspeaking,race)impact the likelihood of receiving an inappropriate dose.METHODS:This is a retrospective,electronic chart review of patients who received a dose of enoxaparin in the ED between January 1,2008 and July 1,2013.We identified all patients>18 years who received a dose of enoxaparin while in the ED,were admitted,and had at least one inpatient weight within the first four days of hospitalization.Patients were excluded if they received enoxaparin for prophylaxis or a dose of more than 1.25mg/kg.RESULTS:A total of 1,944 patients were included.Patients were more likely to experience an error if they did not have a measured ED weight.Over-doses of>10mg were more likely to occur in patients without a measured ED weight.Patients with no documented ED weight or with a staffestimated ED weight were more likely to experience a dosing error than those with a patient-stated weight.Patients were more likely to experience an error if their first inpatient weight was more than 96kg,they were more than 175-cm tall,or were English speaking.CONCLUSION:Dosing errors are more likely to occur when patients are not weighed in the ED.Modifications to current workflows to incorporate weighing those patients who receive weightdosed medications may be warranted.BACKGROUND： The study aimed to determine the frequency of enoxaparin dosing errors for patients who had a measured emergency department （ED） weight compared to those who did not have a measured ED weight, and to determine if demographic variables （e.g., weight, height, age, English-speaking, race） impact the likelihood of receiving an inappropriate dose.METHODS： This is a retrospective, electronic chart review of patients who received a dose of enoxaparin in the ED between January 1, 2008 and July 1, 2013. We identi？ ed all patients 〉18 years who received a dose of enoxaparin while in the ED, were admitted, and had at least one inpatient weight within the ？ rst four days of hospitalization. Patients were excluded if they received enoxaparin for prophylaxis or a dose of more than 1.25 mg/kg. RESULTS： A total of 1,944 patients were included. Patients were more likely to experience an error if they did not have a measured ED weight. Over-doses of 〉10 mg were more likely to occur in patients without a measured ED weight. Patients with no documented ED weight or with a staff-estimated ED weight were more likely to experience a dosing error than those with a patient-stated weight. Patients were more likely to experience an error if their first inpatient weight was more than 96 kg, they were more than 175-cm tall, or were English speaking.CONCLUSION： Dosing errors are more likely to occur when patients are not weighed in the ED. Modifications to current workflows to incorporate weighing those patients who receive weight-dosed medications may be warranted.

关 键 词：ENOXAPARIN Weight-based DOSING EMERGENCY DEPARTMENT DOSING ERRORS 

分 类 号：G43[文化科学—教育学]