Article Text
Abstract
Background Pharmaceutical interventions can prevent drug-related problems and possible prescription errors. They thus contribute to the optimization of pharmacotherapy and to prioritising safety in an Intensive Care Unit (ICU).
Purpose To identify and quantify medicines errors observed and interventions made in the ICU in question, drawing a profile of the main actions of the pharmacist in critical care specialising in women’s health.
Materials and Methods The study was conducted in a Brazilian ICU of a university hospital specialising in women’s health, from February to May 2012. Interventions were performed after analysis of patient prescriptions (18 years old or over, hospitalised for more than 24 hours in the ICU) and discussions of clinical cases during multidisciplinary meetings. Interventions were classed on whether or not they were accepted by the medical staff. Drug-related errors observed were classed as preventable or not and ranked by an adaptation of the classification of the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP).
Results The study involved 82 patients, and 386 prescriptions were evaluated. The mean age was 41.1 ± 19.0 years old and the average hospital stay was 4.7 ± 3.3 days. We identified 45 medicines errors (mean 0.6 ± 3.5/patient), 86.7% of these were preventable and 13.3% were not. The most common error types were: unsafe medicine due to drug interaction (26.7%), higher dose than recommended (15.6%) and unsafe medicine during lactation (13.3%). Fifty-one interventions were made (mean 0.6 ± 4.2/patient), and 84.3% of these were accepted; 3.9% partially accepted; and 11.8% were not accepted. The most common interventions were to recommend an alternative dose (25.5%), identify drug interactions (23.5%), and risk during lactation (11.8%).
Conclusions Partial results obtained show the necessity for clinical pharmacy services in the ICU as an important contribution to reducing risks from drug treatment.
No conflict of interest.