Tatiane Cristina Marques

Errors in medicine administration - profile of medicines: knowing and preventing

Objectives: To describe the pharmacological characteristics of medicines involved in administration errors and determine the frequency of errors with potentially dangerous medicines and low therapeutic index, in clinical units of five teaching hospitals, in Brazil. Methods: Multicentric study, descriptive and exploratory, using the non-participant observation technique (during the administration of 4958 doses of medicines) and the anatomical therapeutic chemical classification (ATC). Results: Of that total, 1500 administration errors were identified (30.3%). The administration of pharmacological groups - ATC (cardiovascular system, nervous system, alimentary tract and metabolism system and anti-infectives for systemic use) showed a higher frequency of errors. In 13.0% of errors were involved potentially dangerous medicines and in 12.2% medicines with low therapeutic index. Conclusion: The knowledge of the pharmacological profile could be an important strategy to be used in the prevention medication errors in health institutions.OBJETIVOS: Descrever as caracteristicas farmacologicas dos medicamentos envolvidos em erros de administracao e determinar a frequencia desses erros com medicamentos potencialmente perigosos e de baixo indice terapeutico em unidades de clinica medica de cinco hospitais de ensino brasileiros. METODOS: Estudo multicentrico, descritivo/exploratorio utilizando a tecnica de observacao nao participante durante a administracao de 4958 doses de medicamentos e a classificacao anatomica terapeutica quimica (ATC). RESULTADOS: Dentre esse total, foram identificados 1500 erros de administracao de medicamentos (30,3%). A administracao dos farmacos dos grupos ATC - sistema cardiovascular, sistema nervoso, trato alimentar e metabolismo e antinfecciosos de uso sistemico apresentou maior frequencia de erros. Em 13,0% dos erros estavam envolvidos medicamentos potencialmente perigosos e em 12,2% medicamentos de baixo indice terapeutico. CONCLUSAO: O conhecimento do perfil farmacologico pode ser uma importante estrategia a ser utilizada na prevencao de erros de medicacao em instituicoes de saude.

Erros de administração de antimicrobianos identificados em estudo multicêntrico brasileiro

Medication administration errors (MAE) are the most frequent kind of medication errors. Errors with antimicrobial drugs (AD) are relevant because they may interfere in patient safety and in the development of microbial resistance. The aim of this study is to analyze the AD errors detected in a Brazilian multicentric study of MAE. It was a descriptive and exploratory study carried out in clinical units in five Brazilian teaching hospitals. The hospitals were investigated during 30 days. MAE were detected by observation technique. MAE were classified in categories: wrong route(WR), wrong patient(WP), wrong dose(WD) wrong time (WT) and unordered drug (UD). AD with MAE were classified by Anatomical-Therapeutical-Chemical Classification System. AD with narrow therapeutic index (NTI) were identified. A descriptive statistical analysis was performed using SPSS version 11.5 software. A total of 1500 errors were observed, 277 (18.5%) of them were errors with AD. The types of AD error were: WT 87.7%, WD 6.9%, WR 1.5%, UD 3.2% and WP 0.7%. The number of AD found was 36. The mostly ATC class were fluoroquinolones 13.9%, combinations of penicillin 13.9%, macrolides 8.3% and third-generation cephalosporins 5.6%. The parenteral drug dosage form was associated with 55.6% of AD. 16.7% of AD were NTI. 47.4% of WD and 21.8% WT were with NTI drugs. This study shows that these errors should be considered potential areas for improvement in the medication process and patient safety plus there is requirement to develop rational drug use of AD.

Medication wrong-route administrations in relation to medical prescriptions

El objetivo fue analizar la influencia de la redaccion de la prescripcion medica en los errores de via de administracion ocurridos en la enfermeria de clinica medica de cinco hospitales brasilenos. Se trata de un estudio descriptivo que utilizo datos de investigacion multicentrica realizada en 2005. La poblacion fue compuesta por 1.425 errores de medicacion y la muestra por 92 errores de via. Las clases farmacologicas mas envueltas en el error fueron: 1) las cardiovasculares (31,5%), 2) las drogas que actuan en el sistema nervioso (23,9%), y 3) las que actuan en el sistema digestivo y metabolismo (13,0%). En lo que se refiere a los items de la prescripcion medica que podrian haber contribuido con los errores de via, se verifico que 91,3% de las prescripciones contenian siglas/abreviaturas; 22,8% no contenian datos del paciente, y 4,3% no presentaban fecha y contenian raspados. Errores de via son frecuentes en los hospitales brasilenos y alrededor del mundo y se sabe que estas situaciones pueden resultar en eventos adversos severos en los pacientes, incluyendo la muerte.

Administração de medicamentos, em vias diferentes das prescritas, relacionada à prescrição médica

El objetivo fue analizar la influencia de la redaccion de la prescripcion medica en los errores de via de administracion ocurridos en la enfermeria de clinica medica de cinco hospitales brasilenos. Se trata de un estudio descriptivo que utilizo datos de investigacion multicentrica realizada en 2005. La poblacion fue compuesta por 1.425 errores de medicacion y la muestra por 92 errores de via. Las clases farmacologicas mas envueltas en el error fueron: 1) las cardiovasculares (31,5%), 2) las drogas que actuan en el sistema nervioso (23,9%), y 3) las que actuan en el sistema digestivo y metabolismo (13,0%). En lo que se refiere a los items de la prescripcion medica que podrian haber contribuido con los errores de via, se verifico que 91,3% de las prescripciones contenian siglas/abreviaturas; 22,8% no contenian datos del paciente, y 4,3% no presentaban fecha y contenian raspados. Errores de via son frecuentes en los hospitales brasilenos y alrededor del mundo y se sabe que estas situaciones pueden resultar en eventos adversos severos en los pacientes, incluyendo la muerte.

Administración de medicamentos en vías diferentes de las indicadas en la prescripción médica

El objetivo fue analizar la influencia de la redaccion de la prescripcion medica en los errores de via de administracion ocurridos en la enfermeria de clinica medica de cinco hospitales brasilenos. Se trata de un estudio descriptivo que utilizo datos de investigacion multicentrica realizada en 2005. La poblacion fue compuesta por 1.425 errores de medicacion y la muestra por 92 errores de via. Las clases farmacologicas mas envueltas en el error fueron: 1) las cardiovasculares (31,5%), 2) las drogas que actuan en el sistema nervioso (23,9%), y 3) las que actuan en el sistema digestivo y metabolismo (13,0%). En lo que se refiere a los items de la prescripcion medica que podrian haber contribuido con los errores de via, se verifico que 91,3% de las prescripciones contenian siglas/abreviaturas; 22,8% no contenian datos del paciente, y 4,3% no presentaban fecha y contenian raspados. Errores de via son frecuentes en los hospitales brasilenos y alrededor del mundo y se sabe que estas situaciones pueden resultar en eventos adversos severos en los pacientes, incluyendo la muerte.

Influência da propaganda na utilização de medicamentos em um grupo de idosos atendidos em uma unidade básica de saúde em Aracaju (SE, Brasil)

The growth of the Brazilian elderly people has led to a trend to an increase in the medication use. The inadequate use of drugs can be induced by some factors, like advertisement, with the risk of damaging the users health. The objective of the study was to evaluate the advertisement influence in medication use in a group of elderly patients in a primary health care unit in Aracaju, Sergipe, Brazil. 230 elderly aging over 60 years with both genders had been interviewed from April to June of 2007. The majority of the interviewees (73%) has at least a chronic health condition and 73.9% consumed regularly at least one medication. 17.8% of the sample informed to use medication motivated by publicity influence; 2.2% had considered that the medication never cause damages and 6.5% believed that always it makes well. In this study, correlations have been made and demonstrated that those who presented a higher level of consumption influenced by advertising also think that drugs used are always beneficial and vice versa (p= 0.04). The data showed that part of elderly suffered influence of advertisement to medication use, and are not conscious of risks involved.

Perfil de medicamentos envueltos en errores de administración: conocer para prevenir

Objectives: To describe the pharmacological characteristics of medicines involved in administration errors and determine the frequency of errors with potentially dangerous medicines and low therapeutic index, in clinical units of five teaching hospitals, in Brazil. Methods: Multicentric study, descriptive and exploratory, using the non-participant observation technique (during the administration of 4958 doses of medicines) and the anatomical therapeutic chemical classification (ATC). Results: Of that total, 1500 administration errors were identified (30.3%). The administration of pharmacological groups - ATC (cardiovascular system, nervous system, alimentary tract and metabolism system and anti-infectives for systemic use) showed a higher frequency of errors. In 13.0% of errors were involved potentially dangerous medicines and in 12.2% medicines with low therapeutic index. Conclusion: The knowledge of the pharmacological profile could be an important strategy to be used in the prevention medication errors in health institutions.OBJETIVOS: Descrever as caracteristicas farmacologicas dos medicamentos envolvidos em erros de administracao e determinar a frequencia desses erros com medicamentos potencialmente perigosos e de baixo indice terapeutico em unidades de clinica medica de cinco hospitais de ensino brasileiros. METODOS: Estudo multicentrico, descritivo/exploratorio utilizando a tecnica de observacao nao participante durante a administracao de 4958 doses de medicamentos e a classificacao anatomica terapeutica quimica (ATC). RESULTADOS: Dentre esse total, foram identificados 1500 erros de administracao de medicamentos (30,3%). A administracao dos farmacos dos grupos ATC - sistema cardiovascular, sistema nervoso, trato alimentar e metabolismo e antinfecciosos de uso sistemico apresentou maior frequencia de erros. Em 13,0% dos erros estavam envolvidos medicamentos potencialmente perigosos e em 12,2% medicamentos de baixo indice terapeutico. CONCLUSAO: O conhecimento do perfil farmacologico pode ser uma importante estrategia a ser utilizada na prevencao de erros de medicacao em instituicoes de saude.

Perfil de medicamentos envolvidos com erros de administração: conhecer para prevenir

Objectives: To describe the pharmacological characteristics of medicines involved in administration errors and determine the frequency of errors with potentially dangerous medicines and low therapeutic index, in clinical units of five teaching hospitals, in Brazil. Methods: Multicentric study, descriptive and exploratory, using the non-participant observation technique (during the administration of 4958 doses of medicines) and the anatomical therapeutic chemical classification (ATC). Results: Of that total, 1500 administration errors were identified (30.3%). The administration of pharmacological groups - ATC (cardiovascular system, nervous system, alimentary tract and metabolism system and anti-infectives for systemic use) showed a higher frequency of errors. In 13.0% of errors were involved potentially dangerous medicines and in 12.2% medicines with low therapeutic index. Conclusion: The knowledge of the pharmacological profile could be an important strategy to be used in the prevention medication errors in health institutions.OBJETIVOS: Descrever as caracteristicas farmacologicas dos medicamentos envolvidos em erros de administracao e determinar a frequencia desses erros com medicamentos potencialmente perigosos e de baixo indice terapeutico em unidades de clinica medica de cinco hospitais de ensino brasileiros. METODOS: Estudo multicentrico, descritivo/exploratorio utilizando a tecnica de observacao nao participante durante a administracao de 4958 doses de medicamentos e a classificacao anatomica terapeutica quimica (ATC). RESULTADOS: Dentre esse total, foram identificados 1500 erros de administracao de medicamentos (30,3%). A administracao dos farmacos dos grupos ATC - sistema cardiovascular, sistema nervoso, trato alimentar e metabolismo e antinfecciosos de uso sistemico apresentou maior frequencia de erros. Em 13,0% dos erros estavam envolvidos medicamentos potencialmente perigosos e em 12,2% medicamentos de baixo indice terapeutico. CONCLUSAO: O conhecimento do perfil farmacologico pode ser uma importante estrategia a ser utilizada na prevencao de erros de medicacao em instituicoes de saude.