Determinação da taxa de segurança do processo de prescrição de medicamentos em um hospital de referência cardiológica do Estado do Ceará

• Autor(a) principal: Oliveira, Sâmia Graciele Maia
• Data de Publicação: 2008
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/4268
• topic: Prescrições de Medicamentos; Erros de Medicação

Medication errors are a great challenge to the rational use of drugs, which is a significant contributing factor to the development of effective and safe health assistance services to patients. Medication errors can occur at various stages in the drug use process. In Brazil, little is known about the profile of errors and the prescription process safety. In order to determine the prevalence rate of errors in prescribing clinically significant drugs (PREPCS) and the safety rate on prescription drug procedures (SRPDP), an exploratory study based on an approach in systematic error estimation was carried out at Cardiology, Pneumology and Pediatrics Units of a reference hospital in the State of Ceará. From August 20 to September 3, 2007, on alternate days, 140 medical prescription – totaling 1,017 items containing drugs – were analyzed. Most medical prescriptions (75% - n=105) were received by the department of pharmacy in the afternoon shift; 61.4% (n=86) had been given to male patients and 22.2% (n=31) had been given to patients between 60 to 69 years of age. In 83.6% (n=117) of records of patients to whom the selected medical prescriptions had been given, no allergy to drugs were reported, and in 60% (n=84) of them the patients’ weight was not informed. In regard to the legal components of the prescriptions, the patient record number was not informed in 63.3% (n=89) prescriptions; the hospital unit was not informed in 59.3% (n=83) prescriptions; the prescriber’s stamp was not stamped in 28.6% (n=40) prescriptions; and 15% (n=21) prescriptions had not been signed by the doctor. Drug-drug interactions were identified in 28.6% (n=40) medical prescriptions; drug-food interactions were identified in 14.3% (n=20) medical prescriptions; and clinically significant prescription errors (CSEP) were found in 25.9% (n=30) medical prescriptions, and the detection of potentially significant drug interactions (26.61% - n=95) was the most recurrent. Most drugs involved in CSEP (63.3% - n=201) belonged to a therapeutic class of cardiovascular medicines and there was suspicion of Adverse Drug Reaction in only 1.8% (n=18) of the prescription drugs. Generic names were most commonly used in the medical prescriptions (60.2% - n=612); and the concentration was not prescribed in 56.4% (n=574) of items containing drugs. The dilluent was prescribed in 35.1% (n=65) of injection drugs, while no infusion speed and hydration solution were prescribed in 59.3% (n=121) of injection drugs. Additional information was prescribed in 14.7% (n=150) of the items containing drugs; and abbreviations were used in 97.6% (n=993) of them, and administration routes were the most common abbreviations used (36% - n =833). And finally, the PREPCS (35.10%) and SRPDP (64.9%) were ascertained, thus indicating the need to reevaluate the process of prescribing and implementing educational strategies. Therefore, the identification of the aforesaid rates is the first step to be taken in order to prevent errors. However, in order to use them at hospitals without creating a punishment environment, the responsibility for the patient’s safety must be collective and an approach in systematic error estimation must be made regularly.