Publicação
Perfil de discrepâncias na farmacoterapia de pacientes internados na unidade pediátrica de um hospital público de alta complexidade no Brasil
| Resumo: | Background: Unintentional discrepancies in pharmacotherapy are conceptualized as incorrectand unjustified errors between the history of drug use and prescriptions during care transitions, an example of hospital admission. These discrepancies when not taking the risk and taking the risk have been a problem with prevent the deficiency or ineffective, incontinent precarious to the treatment and discontinuity of treatment. As children are more susceptible to drug treatment, the analysis of discrepancies in pharmacotherapy may be a relevant strategy to improve communication between health professionals and prescribers in this population. In this sense, the objective of this study was to analyze discrepancies in pharmacotherapy during the admission and internal transference of a hospital of high complexity. Method: Patients from 0 to 12 years of age were not evaluated without admission to the pediatrics. Data collection was performed between August 2017 and March 2018 and the following steps: 1- The collection of sociodemographic data; 2 - clinical interview with the patient's caregiver; 3 - registration of the patient's prescription of admission and the first prescription made after an internal registration; 4 assessments of patient records for the history of pharmacotherapy registered by nursing staff. The discrepancies were classified as intentional, when there was documented justification for changes in pharmacotherapy, and not intentional. The following were classified as: omission of drugs; dose, rate or route of administration other than previous history; once different from previous history and therapeutic duplicity. Results: A total of 136 patients participated in the study, of which 72 (53%) were males and 64 (47%) were females, with a mean age of six years. Of these, 20 (14.7%) elderly health problems and 116 (85.3%) acute problems. 21 (15.4%) patients discrepancies on hospital admission and 70 (51.5%) patients on transfer to the ward. As for drugs that unintentional discrepancies, 24 were created on admission and 74 on transfer. The effects of the medication were more intense in omission (70.8%) and dose (20.8%) in the internal dose by default (52.7%) and dose (35.5%). Conclusion: The majority of patients hospitalized for acute health problems, which explains the use of hospitalization rates and justifies the rate of discrepancy during hospitalization when compared to an internal transfer rate. This may be the indicator of communication difficulties between health teams and low process management. As a consequence, they may trigger discontinuities in treatment of adverse reactions or adversities due to errors in dosages, routes of administration, frequency of administration or prescription of different drugs. |
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| Autores principais: | Araújo Neto, Fernando de Castro |
| Assunto: | Farmácia Ensino de farmácia Segurança do paciente Crianças Medicamentosas Serviços clínicos farmacêuticos Pediatria Patient safety Children Drug discrepancies Clinical pharmacy services Drug reconciliation CIENCIAS DA SAUDE::FARMACIA |
| Ano: | 2019 |
| País: | Brasil |
| Tipo de documento: | trabalho de fim de curso |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | IBICT |
| Idioma: | português |
| Origem: | Oasisbr |
| Resumo: | Background: Unintentional discrepancies in pharmacotherapy are conceptualized as incorrectand unjustified errors between the history of drug use and prescriptions during care transitions, an example of hospital admission. These discrepancies when not taking the risk and taking the risk have been a problem with prevent the deficiency or ineffective, incontinent precarious to the treatment and discontinuity of treatment. As children are more susceptible to drug treatment, the analysis of discrepancies in pharmacotherapy may be a relevant strategy to improve communication between health professionals and prescribers in this population. In this sense, the objective of this study was to analyze discrepancies in pharmacotherapy during the admission and internal transference of a hospital of high complexity. Method: Patients from 0 to 12 years of age were not evaluated without admission to the pediatrics. Data collection was performed between August 2017 and March 2018 and the following steps: 1- The collection of sociodemographic data; 2 - clinical interview with the patient's caregiver; 3 - registration of the patient's prescription of admission and the first prescription made after an internal registration; 4 assessments of patient records for the history of pharmacotherapy registered by nursing staff. The discrepancies were classified as intentional, when there was documented justification for changes in pharmacotherapy, and not intentional. The following were classified as: omission of drugs; dose, rate or route of administration other than previous history; once different from previous history and therapeutic duplicity. Results: A total of 136 patients participated in the study, of which 72 (53%) were males and 64 (47%) were females, with a mean age of six years. Of these, 20 (14.7%) elderly health problems and 116 (85.3%) acute problems. 21 (15.4%) patients discrepancies on hospital admission and 70 (51.5%) patients on transfer to the ward. As for drugs that unintentional discrepancies, 24 were created on admission and 74 on transfer. The effects of the medication were more intense in omission (70.8%) and dose (20.8%) in the internal dose by default (52.7%) and dose (35.5%). Conclusion: The majority of patients hospitalized for acute health problems, which explains the use of hospitalization rates and justifies the rate of discrepancy during hospitalization when compared to an internal transfer rate. This may be the indicator of communication difficulties between health teams and low process management. As a consequence, they may trigger discontinuities in treatment of adverse reactions or adversities due to errors in dosages, routes of administration, frequency of administration or prescription of different drugs. |
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