Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação
Autor(a) principal: | |
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Data de Publicação: | 2016 |
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/22532 |
Resumo: | The complexity of care in Intensive Care Units (ICUs) exposes critically ill patients to a high risk of Adverse Drug Events, with the occurrence of Medication Errors being prevalent. The present study aimed to analyze the clinical pharmacy activities performed in the ICU of a hospital of medium and high private complexity and the results achieved in the identification, resolution and prevention of MS. This is a prospective study with an analytical approach in which the incidence, type, severity and factors associated with MS identified during the analysis of prescriptions, performed from February to July / 2016, and during the Medicinal Conciliation ( CM), carried out from April to June / 2016. Patients who had the prescription or CM performed by the pharmacist during the established period were included. The results achieved with the Pharmaceutical Interventions (FI) were verified. The SPSS and Stata programs were used to analyze the data. Categorical variables were compared using the chi-square or Fisher's exact test. A value of p <0.05 was considered statistically significant. To estimate factors associated with MS, a logistic regression was performed, with odds ratio and confidence interval (CI) calculation (95%). The study was approved by the institution's Research Ethics Committee. Analyzes of 1,502 prescriptions were performed, totaling 465 patients. The incidence of MS in this stage was 77.3 (95% CI 55.5-99.1) per 1,000 patient-days. Regarding severity, 59.6% (n = 199) of the errors reached the patient, did not cause damage, but required monitoring. The main MS identified was drug-drug interaction (44.6%, n = 149), followed by preparation, handling or packaging errors (18%, n = 60) and overdose (11.1%, n = 37) . A total of 334 IFs were performed and 79.3% (n = 265) were accepted. The occurrence of MS was significantly associated with: length of hospital stay before ICU admission> 5 days; Length of stay in the ICU> 5 days; Type of nutrition, use of mechanical ventilation, hemodialysis, number of drugs> 10, number of injectable drugs> 10, use of antimicrobials, vasoactive drugs, analgesics and sedatives. A total of 136 patients were admitted to the study, of whom 126 (92.6%) used at least one medication. The incidence of medication errors at this stage was 16.3% (95% CI 11.5-21.2). 128 IF and 71.1% (n = 91) were accepted. As to severity, 65.5% (n = 80) of the errors reached the patient, but there was no damage. The risk factors for the occurrence of medication errors in the conciliation were: age ≥ 60 years, number of comorbidities> 1 and previous use of 9 or more drugs. The study made it possible to identify the type, severity, incidence and factors associated with the occurrence of MS in the ICU. It was verified that the clinical pharmacist's performance is well accepted and contributes to the resolution, prevention and monitoring of medication errors, focusing on patient safety. patient. |
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Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicaçãoClinical pharmacy in intensive care unit: identification, resolution and prevention of medication errorsCuidados CríticosUnidades de Terapia IntensivaErros de MedicaçãoSegurança do PacienteReconciliação de MedicamentosUso de MedicamentosThe complexity of care in Intensive Care Units (ICUs) exposes critically ill patients to a high risk of Adverse Drug Events, with the occurrence of Medication Errors being prevalent. The present study aimed to analyze the clinical pharmacy activities performed in the ICU of a hospital of medium and high private complexity and the results achieved in the identification, resolution and prevention of MS. This is a prospective study with an analytical approach in which the incidence, type, severity and factors associated with MS identified during the analysis of prescriptions, performed from February to July / 2016, and during the Medicinal Conciliation ( CM), carried out from April to June / 2016. Patients who had the prescription or CM performed by the pharmacist during the established period were included. The results achieved with the Pharmaceutical Interventions (FI) were verified. The SPSS and Stata programs were used to analyze the data. Categorical variables were compared using the chi-square or Fisher's exact test. A value of p <0.05 was considered statistically significant. To estimate factors associated with MS, a logistic regression was performed, with odds ratio and confidence interval (CI) calculation (95%). The study was approved by the institution's Research Ethics Committee. Analyzes of 1,502 prescriptions were performed, totaling 465 patients. The incidence of MS in this stage was 77.3 (95% CI 55.5-99.1) per 1,000 patient-days. Regarding severity, 59.6% (n = 199) of the errors reached the patient, did not cause damage, but required monitoring. The main MS identified was drug-drug interaction (44.6%, n = 149), followed by preparation, handling or packaging errors (18%, n = 60) and overdose (11.1%, n = 37) . A total of 334 IFs were performed and 79.3% (n = 265) were accepted. The occurrence of MS was significantly associated with: length of hospital stay before ICU admission> 5 days; Length of stay in the ICU> 5 days; Type of nutrition, use of mechanical ventilation, hemodialysis, number of drugs> 10, number of injectable drugs> 10, use of antimicrobials, vasoactive drugs, analgesics and sedatives. A total of 136 patients were admitted to the study, of whom 126 (92.6%) used at least one medication. The incidence of medication errors at this stage was 16.3% (95% CI 11.5-21.2). 128 IF and 71.1% (n = 91) were accepted. As to severity, 65.5% (n = 80) of the errors reached the patient, but there was no damage. The risk factors for the occurrence of medication errors in the conciliation were: age ≥ 60 years, number of comorbidities> 1 and previous use of 9 or more drugs. The study made it possible to identify the type, severity, incidence and factors associated with the occurrence of MS in the ICU. It was verified that the clinical pharmacist's performance is well accepted and contributes to the resolution, prevention and monitoring of medication errors, focusing on patient safety. patient.A complexidade do cuidado em Unidades de Terapia Intensiva (UTI) expõe os pacientes críticos a um risco elevado de Eventos Adversos a Medicamentos, sendo prevalente a ocorrência de Erros de Medicação (EM). O presente estudo objetivou analisar as atividades de farmácia clínica realizadas na UTI de um hospital de média e alta complexidade privado e os resultados alcançados na identificação, resolução e prevenção de EM. Trata-se de um estudo prospectivo, com abordagem analítica, no qual foram avaliadas a incidência, tipo, gravidade e fatores associados aos EM identificados durante as análises de prescrições, realizadas no período de fevereiro a julho/2016, e durante as Conciliações Medicamentosas (CM), realizadas no período de abril a junho/2016. Foram incluídos os pacientes que tiveram a prescrição avaliada ou a CM realizada pelo farmacêutico, no período estabelecido. Os resultados alcançados com as Intervenções Farmacêuticas (IF) foram verificados. Para análise dos dados foi utilizado os programas SPSS e Stata. As variáveis categóricas foram comparadas utilizando o teste qui-quadrado ou exato de Fisher. Um valor de p<0,05 foi considerado estatisticamente significativo. Para estimar fatores associados com EM foi realizada regressão logística, com cálculo da odds ratio e do intervalo de confiança (IC) (95%). O estudo foi aprovado no Comitê de Ética em Pesquisa da instituição. Foram realizadas análises de 1.502 prescrições, totalizando 465 pacientes. A incidência de EM nessa etapa foi de 77,3 (IC 95% 55,5-99,1) por 1.000 pacientes-dia. Quanto a gravidade, 59,6% (n=199) dos erros atingiram o paciente, não causaram danos, mas necessitaram de monitoramento. O principal EM identificado foi a interação medicamento-medicamento (44,6%, n=149), seguido pelos erros de preparo, manipulação ou acondicionamento (18%, n=60) e sobredose (11,1%, n=37). Foram realizadas 334 IF e 79,3% (n=265) foram aceitas. A ocorrência de EM mostrou associação significativa com: tempo de permanência hospitalar antes da admissão na UTI > 5 dias; tempo de permanência na UTI > 5 dias; tipo de nutrição, uso de ventilação mecânica, hemodiálise, nº de medicamentos >10, nº de medicamentos injetáveis >10, uso de antimicrobianos, fármacos vasoativos, analgésicos e sedativos. Foi realizada CM com 136 pacientes admitidos, dos quais 126 (92,6%) faziam uso habitual de pelo menos um medicamento. A incidência de erros de medicação, nessa etapa, foi de 16,3% (IC 95% 11,5-21,2). Foram realizadas 128 IF e 71,1% (n=91) foram aceitas. Quanto à gravidade, 65,5% (n=80) dos erros atingiram o paciente, mas não houve dano. Os fatores de risco para ocorrência de erros de medicação, na conciliação, foram: idade ≥ a 60 anos, nº de comorbidades > 1 e uso prévio de 9 ou mais medicamentos. O estudo realizado permitiu identificar o tipo, gravidade, incidência e fatores associados à ocorrência de EM em UTI, sendo constatado que a atuação do farmacêutico clínico tem boa aceitação e contribui para resolução, prevenção e monitorização de erros de medicação, com foco na segurança do paciente.Fonteles, Marta Maria de FrançaAdriano, Liana Silveira2017-04-17T16:03:01Z2017-04-17T16:03:01Z2016-12-13info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfADRIANO, L. S. Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação. 2016. 76 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2016.http://www.repositorio.ufc.br/handle/riufc/22532porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2018-12-27T13:36:00Zoai:repositorio.ufc.br:riufc/22532Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:28:17.693583Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false |
dc.title.none.fl_str_mv |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação Clinical pharmacy in intensive care unit: identification, resolution and prevention of medication errors |
title |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
spellingShingle |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação Adriano, Liana Silveira Cuidados Críticos Unidades de Terapia Intensiva Erros de Medicação Segurança do Paciente Reconciliação de Medicamentos Uso de Medicamentos |
title_short |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
title_full |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
title_fullStr |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
title_full_unstemmed |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
title_sort |
Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação |
author |
Adriano, Liana Silveira |
author_facet |
Adriano, Liana Silveira |
author_role |
author |
dc.contributor.none.fl_str_mv |
Fonteles, Marta Maria de França |
dc.contributor.author.fl_str_mv |
Adriano, Liana Silveira |
dc.subject.por.fl_str_mv |
Cuidados Críticos Unidades de Terapia Intensiva Erros de Medicação Segurança do Paciente Reconciliação de Medicamentos Uso de Medicamentos |
topic |
Cuidados Críticos Unidades de Terapia Intensiva Erros de Medicação Segurança do Paciente Reconciliação de Medicamentos Uso de Medicamentos |
description |
The complexity of care in Intensive Care Units (ICUs) exposes critically ill patients to a high risk of Adverse Drug Events, with the occurrence of Medication Errors being prevalent. The present study aimed to analyze the clinical pharmacy activities performed in the ICU of a hospital of medium and high private complexity and the results achieved in the identification, resolution and prevention of MS. This is a prospective study with an analytical approach in which the incidence, type, severity and factors associated with MS identified during the analysis of prescriptions, performed from February to July / 2016, and during the Medicinal Conciliation ( CM), carried out from April to June / 2016. Patients who had the prescription or CM performed by the pharmacist during the established period were included. The results achieved with the Pharmaceutical Interventions (FI) were verified. The SPSS and Stata programs were used to analyze the data. Categorical variables were compared using the chi-square or Fisher's exact test. A value of p <0.05 was considered statistically significant. To estimate factors associated with MS, a logistic regression was performed, with odds ratio and confidence interval (CI) calculation (95%). The study was approved by the institution's Research Ethics Committee. Analyzes of 1,502 prescriptions were performed, totaling 465 patients. The incidence of MS in this stage was 77.3 (95% CI 55.5-99.1) per 1,000 patient-days. Regarding severity, 59.6% (n = 199) of the errors reached the patient, did not cause damage, but required monitoring. The main MS identified was drug-drug interaction (44.6%, n = 149), followed by preparation, handling or packaging errors (18%, n = 60) and overdose (11.1%, n = 37) . A total of 334 IFs were performed and 79.3% (n = 265) were accepted. The occurrence of MS was significantly associated with: length of hospital stay before ICU admission> 5 days; Length of stay in the ICU> 5 days; Type of nutrition, use of mechanical ventilation, hemodialysis, number of drugs> 10, number of injectable drugs> 10, use of antimicrobials, vasoactive drugs, analgesics and sedatives. A total of 136 patients were admitted to the study, of whom 126 (92.6%) used at least one medication. The incidence of medication errors at this stage was 16.3% (95% CI 11.5-21.2). 128 IF and 71.1% (n = 91) were accepted. As to severity, 65.5% (n = 80) of the errors reached the patient, but there was no damage. The risk factors for the occurrence of medication errors in the conciliation were: age ≥ 60 years, number of comorbidities> 1 and previous use of 9 or more drugs. The study made it possible to identify the type, severity, incidence and factors associated with the occurrence of MS in the ICU. It was verified that the clinical pharmacist's performance is well accepted and contributes to the resolution, prevention and monitoring of medication errors, focusing on patient safety. patient. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-12-13 2017-04-17T16:03:01Z 2017-04-17T16:03:01Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
ADRIANO, L. S. Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação. 2016. 76 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2016. http://www.repositorio.ufc.br/handle/riufc/22532 |
identifier_str_mv |
ADRIANO, L. S. Farmácia clínica em unidade de terapia intensiva: identificação, resolução e prevenção de erros de medicação. 2016. 76 f. Dissertação (Mestrado em Ciências Farmacêuticas) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2016. |
url |
http://www.repositorio.ufc.br/handle/riufc/22532 |
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openAccess |
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Repositório Institucional da Universidade Federal do Ceará (UFC) |
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Repositório Institucional da Universidade Federal do Ceará (UFC) |
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Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC) |
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