Analysis of omission of antimicrobial doses in Intensive Care Units.
Isabelle Ribeiro Machado, Danielle de Mendonça Henrique, Flávia Giron Camerini and 3 others
PMID 39699367WHAT IT FOUND
ICU antimicrobial doses were omitted in 4.29% of 1,467 doses.
Double checking was associated with 30% lower omission, but this observational study cannot prove it caused the reduction.
Key findings
01The analysis included 452 prescriptions from 94 patients, and the antimicrobial dose omission rate was 4.29% among 1,467 doses, with 63 omitted doses.
02Double checking was performed on 260 prescriptions, 11 of which had omitted doses, and the paper reports a 30% reduction in omission with double checking.
03Each antimicrobial prescribed was associated with a 51% higher chance of dose omission.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational and based on records, so it cannot show that double checking caused fewer omissions. Dose omission was inferred from prescriptions and nursing records; doses not checked or circled without justification were counted as omitted, which may include documentation failure. The study could not observe specific repercussions for the most affected groups. Data transfer between systems may have caused missing information and exclusion of prescriptions. It was conducted in a university hospital setting, so other ICU populations may differ.
Declared interests
The supplied text lists funding by a state research foundation and does not report author commercial conflicts.
The easy way to misread this
Do not conclude that double checking caused a 30% reduction in omissions. The study was observational, and omissions were judged from records, so missing checks or notes may mean documentation failure rather than true omission.