RESUMEN
Erros de medicação são constantemente relatados na literatura médico-científica. Há casos clínicos em que a administração inadequada de doses altas de alguns citostáticos tem como consequência a toxicidade grave e a morte do paciente. As não conformidades presentes nas prescrições aos pacientes oncológicos podem ser catastróficas em função da estreita margem terapêutica dos medicamentos antineoplásicos. Prevenir erros de medicação torna-se uma prioridade na melhora do processo farmacoterapêutico em pacientes da oncologia. A multidisciplinaridade é um fator essencial de alerta aos erros de medicação de antineoplásicos e às maneiras de preveni-los. Os farmacêuticos e todos os profissionais que constituem uma equipe multidisciplinar de saúde contribuem para garantia do uso seguro dos medicamentos, o que auxilia no aprimoramento de uma assistência qualificada. Para isso, além das atividades já bem estabelecidas, esses profissionais devem (i) implantar um sistema de validação farmacêutica bem como (ii) estabelecer um sistema de verificação da prescrição médica, o qual consiste em diferentes etapas. O objetivo dessa revisão é relatar a validação da prescrição médica, considerando-se os erros de medicação na quimioterapia e o papel do farmacêutico na prevenção desses erros. São medidas que visam a melhorar a qualidade da assistência prestada aos pacientes oncológicos.
Medication errors have been frequently reported in the literature. There have been several clinical cases in which the improper administration of high doses of some cytostatics resulted in serious toxicity and patients death. Nonconformities in oncology patients prescriptions can lead to serious problems due to the narrow therapeutic range of antineoplastic drugs. Preventing medication errors has become a priority on improving the pharmacotherapeutic process in oncology patients. The presence of a multidisciplinary staff is an important instrument to improve awareness of medication errors and to prevent them. Pharmacists and other health providers that participate in the multidisciplinary team contribute to ensure the safe use of medications and to improve the delivery of quality care. In addition to their well established activities these professionals should: (i) set up a pharmaceutical validation system and (ii) establish a prescription verification system including several checkpoints. The objective of this review of the literature is to report on prescription validation, considering some chemotherapy medication errors and the pharmacists role in preventing them. These measures are aimed at improving the quality of the care provided to oncology patients.
Asunto(s)
Humanos , Masculino , Femenino , Antineoplásicos , Antineoplásicos/farmacología , Antineoplásicos/toxicidad , Antineoplásicos/uso terapéutico , Errores de Medicación/efectos adversos , Errores de Medicación/legislación & jurisprudencia , Errores de Medicación/métodos , Errores de Medicación/mortalidad , Errores de Medicación/prevención & control , Farmacéuticos/normas , Composición de Medicamentos , Composición de Medicamentos/métodos , Composición de Medicamentos/mortalidadRESUMEN
AIM: To verify the frequency of errors in the preparation and administration of intravenous medication in three Brazilian hospitals in the State of Bahia. BACKGROUND: The administration of intravenous medications constitutes a central activity in Brazilian nursing. Errors in performing this activity may result in irreparable damage to patients and may compromise the quality of care. DESIGN: Cross-sectional study, conducted in three hospitals in the State of Bahia, Brazil. METHODS: Direct observation of the nursing staff (nurse technicians, auxiliary nurses and nurse attendants), preparing and administering intravenous medication. RESULTS: When preparing medication, wrong patient error did not occur in any of the three hospitals, whereas omission dose was the most frequent error in all study sites. When administering medication, the most frequent errors in the three hospitals were wrong dose and omission dose. CONCLUSIONS: The rates of error found are considered low compared with similar studies. The most frequent types of errors were wrong dose and omission dose. The hospitals studied showed different results with the smallest rates of errors occurring in hospital 1 that presented the best working conditions. Relevance to clinical practice. Studies such as this one have the potential to improve the quality of care.