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5PSQ-129 Balance and classification of pharmaceutical interventions in a general hospital of specialties: the personalised hospital pharmacy
  1. F Gomez-de Rueda1,
  2. I Elósegui Horno2,
  3. B Cancela Díezl1,
  4. F Horno Ureña2
  1. 1Complejo Hospitalario de Jaén, Hospital Pharmacy Clinical Pharmacotherapy, Jaén, Spain
  2. 2Complejo Hospitalario de Jaén, Hospital Pharmacy, Jaén, Spain


Background Pharmaceutical care (PC) is the ‘supply of medicines with the purpose of achieving concrete results that improve the quality of life of the patient’, being related to the global process of prescription through pharmaceutical intervention (PI).

Purpose Analyse the registration data of the PIs carried out in a tertiary hospital to avoid adverse effects and health hazards.

Material and methods Retrospective study of the PIs registered between January and August 2018. The PIs were structured in three blocks: Block 1: qualitative (method of comunication of PIs); Block 2: quantitative (active principle, schedules, drugs included/not included in the Pharmacotherapeutic Guide (PTG) and dose adjustment in paediatric presentations); and Block 3: communicative (computer or telephone/personal), dose adjustment according to renal and hepatic functions and acceptance degree.

Results There were 573 PIs over 12 024 admissions, 72.6% in adults and 27.4% in paediatrics. The main method of communication was the computer on 408 occasions and telephone/personal in 165, depending on the urgency. The most frequent error was schedule (43%), not adjusting for nursing shifts, altering the administration of the medication. Those of active principle (26%) were due to drugs not included in the PTG and of those doses (18%) that were related to paediatric presentations. The inadequate form of administration was also registered in 6%, being related to the prescription of medications not included in the PTG, requiring a complete description sensitive to faults in the prescription or transcription. Those of low posology (4%) were due to dose adjustment according to renal and hepatic functions, and those of high (3%) to shortening of the therapeutic interval. The ‘pharmaceutical performance’ included 63 PIs of therapeutic exchange and modified dosages in 29 cases. Acceptance was 97.5%, performing 98.6% immediately and 1.4% in a range of 8 hours. All these problems related to the medication were detected and corrected by pharmacists as the intermediate step between the medical prescription and the nursing administration.

Conclusion It has been shown that the review and validation of treatments significantly improves therapeutic safety, minimising the risk to the patient. These results provide quantifiable data to measure the activity of the clinical pharmacist, in addition to providing data on pharmacotherapeutic quality indicators.

References and/or acknowledgements Database Pharmacy Unit.

No conflict of interest.

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