Eugenie Desirèe Rabelo Néri

Erros de prescrição de medicamentos em um hospital brasileiro

OBJECTIVE: To identify the prevalence of clinically significant prescription errors in a Brazilian university hospital compared with their occurrence in 2003 and 2007. METHODS: Variables and group of variables, such as readability, compliance with legal and institutional procedures of prescription, and prescription errors analysis were analyzed. RESULTS: When the prevalence rates of clinically significant prescription errors were calculated, a statistically significant decrease was shown [year of 2003 (29.25%), year of 2007 (24.20%); (z = 2.99; p = 0.03)], reflecting on the safety rate [year of 2003 (70.75%), year of 2007 (75.80%); (z = 3.30; p =0.0001)]. CONCLUSION: Despite significant, the increased safety rate reflected the quantitative reduction of errors, with no observed difference in severity between the studied periods. Our results suggest the institutional steps taken could reduce the number of errors, but they were ineffective in reducing the severity of the errors.

O custo do transplante hepático em um hospital universitário do Brasil

OBJETIVO: Investigar se os transplantes de figado realizados em um hospital universitario do Ceara eram custos-efetivos. METODOS: Foram avaliados os prontuarios dos 62 pacientes transplantados hepaticos em 2007, do dia da internacao para o transplante ate a data da alta hospitalar ou obito. Foram determinados indicadores como o numero de dias e local de internacao, a quantidade de material e medicamentos utilizados, os exames complementares e os procedimentos realizados. RESULTADOS: A maioria da populacao era do sexo masculino, procedente do Nordeste e com idade media de 45 anos. O custo medio do transplante hepatico foi de US

Drug prescription errors in a Brazilian hospital

20.605,01. O item que onerou predominantemente o custo foi o repasse para equipe profissional envolvida na captacao e transplante; seguido pelas diarias, medicamentos da cirurgia e internamento; e produtos (materiais e medicamentos) utilizados na captacao. Quanto ao repasse do SUS, o HUWC recebeu US

Implementation of a penicillin allergy skin test

1.322,97 para a captacao, US

Environmental variables and errors in the preparation and administration of medicines

3.223,56 para os honorarios medicos e US

Drug interactions resulting from scheduling and errors in the preparation of antibacterials

32.235,68 pelo pacote do transplante hepatico que inclui do procedimento cirurgico ate o setimo dia de internamento. CONCLUSAO: Os valores encontrados foram semelhantes aos determinados por outros centros transplantadores brasileiros. O transplante hepatico no Ceara e um procedimento economicamente viavel tomando como base o repasse financeiro do SUS.

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey

OBJECTIVE To identify the prevalence of clinically significant prescription errors in a Brazilian university hospital compared with their occurrence in 2003 and 2007. METHODS Variables and group of variables, such as readability, compliance with legal and institutional procedures of prescription, and prescription errors analysis were analyzed. RESULTS When the prevalence rates of clinically significant prescription errors were calculated, a statistically significant decrease was shown [year of 2003 (29.25%), year of 2007 (24.20%); (z = 2.99; p = 0.03)], reflecting on the safety rate [year of 2003 (70.75%), year of 2007 (75.80%); (z = 3.30; p =0.0001)]. CONCLUSION Despite significant, the increased safety rate reflected the quantitative reduction of errors, with no observed difference in severity between the studied periods. Our results suggest the institutional steps taken could reduce the number of errors, but they were ineffective in reducing the severity of the errors.

Orientação farmacêutica na alta hospitalar de pacientes transplantados: estratégia para a segurança do paciente

The penicillin allergy skin testing is the only accurate and reliable test for penicillin hypersensitivity mediated by IgE. It is useful for identifying patients with doubtful history of allergy. Positive test for major and minor determinants presents a positive predictive value of 50% and negative predictive value of 99%. In Brazil, the Ministry of Health suggests a protocol for in house made reagents, since they are not commercially available. As the referred protocol does not mention some important details about the test procedures, we propose in the present work to implement them, critically evaluating each step in order to allow the protocol establishment at any health service, with quality and safety.

Análise da rotulagem de medicamentos semelhantes: potenciais erros de medicação

OBJECTIVE to identify the relationship between environmental factors and errors in the preparation and administration of antibacterial. METHOD an observational, cross-sectional study conducted between August and December, 2014 in two clinical units. The sample consisted of 265 doses of medication, observed in different shifts that through a form had the environmental conditions of noise, illumination, humidity, temperature and physical space measured in the preparation and administration stages. RESULTS the physical dimension for the preparation was inadequate in one unit (3.8m2), and the items illumination, temperature and noise were extremely oscillating in the three shifts and in the two clinics, with averages generally higher than the recommended for the hospital environment, however, variations in illumination and noise were not statistically significant to cause dose errors or erroneous medicine choice (p> 0.05). CONCLUSION the environmental variables analyzed may favor medication errors in both the preparation and administration stages.

ERROS NA ÁREA DA SAÚDE: CULPADO OU INOCENTE?

Objetivo: identificar as interacoes medicamentosas induzidas pelo aprazamento e os erros no preparo de antibacterianos administrados. Metodos: estudo observacional e transversal, realizado em clinicas medicas de hospital da rede sentinela. A coleta de dados ocorreu por meio da observacao das prescricoes e do preparo de 265 doses de antibacterianos com a utilizacao de um check-list. Resultados: prevaleceu a administracao da Piperaciclina e Tazobactan, com 51 doses. O aprazamento de horario dos antibacterianos com outro medicamento ocorreu prevalentemente no periodo matutino, destacando-se interacoes com anticoagulantes injetaveis e entre antimicrobianos de classes diferentes, e se associou com a nao disponibilizacao no setor de orientacoes impressas acerca dos cuidados com a administracao do medicamento (p=0,003). O principal erro encontrado foi o de dose (32,5%). Conclusao: o aprazamento de antibacterianos em setor de clinica medica pode potencializar possiveis interacoes medicamentosas e os erros de dose sao identificados na administracao dos medicamentos.