Constantino José Fernandes Junior

Reduced frequency of cardiopulmonary arrests by rapid response teams

OBJECTIVE To evaluate the impact of the implementation of a rapid response team on the rate of cardiorespiratory arrests in mortality associated with cardiorespiratory arrests and on in-hospital mortality in a high complexity general hospital. METHODS A retrospective analysis of cardiorespiratory arrests and in-hospital mortality events before and after implementation of a rapid response team. The period analyzed covered 19 months before intervention by the team (August 2005 to February 2007) and 19 months after the intervention (March 2007 to September 2008). RESULTS During the pre-intervention period, 3.54 events of cardiorespiratory arrest/1,000 discharges and 16.27 deaths/1,000 discharges were noted. After the intervention, there was a reduction in the number of cardiorespiratory arrests and in the rate of in-hospital mortality; respectively, 1.69 events of cardiorespiratory arrest/1,000 discharges (p < 0.001) and 14.34 deaths/1,000 discharges (p = 0.029). CONCLUSION The implementation of the rapid response team may have caused a significant reduction in the number of cardiorespiratory arrests. It was estimated that during the period from March 2007 to September 2008, the intervention probably saved 67 lives.

Contribuição da farmácia na prescrição e uso racional de albumina humana em um hospital de grande porte

Objetivo: O trabalho teve como objetivo a reducao da utilizacao de albumina humana 20% com indicacao nao-fundamentada no Hospital Israelita Albert Einstein. Metodos: Durante um periodo de 30 dias (dezembro, 2006), foi realizada uma analise prospectiva preliminar utilizando-se as prescricoes medicas de pacientes com Albumina humana, e avaliaram-se as indicacoes terapeuticas em relacao as diretrizes estabelecidas pela resolucao ANVISA RDC 115. A partir dessas informacoes, foi elaborado um projeto de atuacao e foi instituida uma rotina de acompanhamento diario das prescricoes pelos farmaceuticos a partir de Janeiro de 2007. Resultados: De Janeiro a Outubro de 2007, foram consumidos 14.799 frascos de albumina 20%. Destes, 4.191 com indicacao nao fundamentada, correspondendo a uma perda de R

Pharmacy contribution to the prescription and rational use of human albumin at a large hospital

1,36 milhoes. Em 2008 (de janeiro a outubro), foram prescritos 13.519 frascos de albumina 20%. Destes, 1.648 com indicacao nao fundamentada, o que responde por uma perda de R

Melhoria de desempenho e desfechos (mortalidade) após implementação de um protocolo institucional de atendimento a pacientes sépticos

535 mil. A relacao entre o risco da perda e quantidade consumida de janeiro a outubro de 2007 foi de 91,99. Ja no mesmo periodo de 2008 foi de 39,60. De janeiro a outubro de 2007, a media do percentual de albumina prescrita com indicacao nao-fundamentada foi de 28%. No mesmo periodo em 2008, este percentual caiu para 13%. Uma reducao de 54%. Conclusoes: O envolvimento do Farmaceutico no processo de verificacao da indicacao e justificativa do uso do medicamento representa processos seguros ao paciente, garantindo que ele receba o medicamento certo para a indicacao correta, reduzindo com isto a probabilidade de eventos adversos e contribuindo para diminuir burocracias e gastos desnecessarios na instituicao.

Impacto de cada ação dos pacotes da Surviving Sepsis Campaign na mortalidade hospitalar de pacientes portadores de sepse grave/choque séptico

OBJECTIVE The purpose of this survey was to reduce the use of human albumin 20% in non-supported indications at Hospital Israelita Albert Einstein. METHODS During a 30-day period, in December 2006, a preliminary prospective analysis of medical prescriptions of human albumin 20% and therapeutic indications according to ANVISA RDC 115 guidelines was performed. Based on this analysis, a project was developed. In January 2007, a daily routine to follow up albumin prescriptions by the Hospital pharmacists was established. RESULTS From January to October 2007, 14,799 vials of albumin 20% were used, out of which 4,191 had non-supported indications, resulting in a R

Curso de Atualização em Emergências Médicas: aula 19: reposição volêmica

1.36 million loss. In 2008 (from January to October), 13,519 vials of albumin 20% were prescribed, and 1,648 of them had non-supported indications, causing a R

Disfunção cardíaca na sepse

535 thousand loss. The ratio between loss risk and consumed amount was 91.99 between January and October 2007. During the same period in 2008, this ratio was 39.60. Between January and October 2007, the average percentage of albumin prescribed for non-supported indications was 28%, whereas this percentage dropped to 13%, i.e., a decrease by 54%, during the same period of 2008. CONCLUSIONS The inclusion of a pharmacist in the process of verifying medicine indications and justification of use was translated into safer processes to patients, ensuring that they received the correct medication for the correct indication, therefore reducing the chance of adverse events and contributing to reduce red-tape procedures and unnecessary expenditures by the institution.