Prevención de potenciales errores de medicamentos en las unidades móviles de emergencias
01 Mar 2010-Farmacia Hospitalaria (Elsevier)-Vol. 34, Iss: 2, pp 96-97
About: This article is published in Farmacia Hospitalaria.The article was published on 2010-03-01 and is currently open access. It has received None citations till now.
TL;DR: Computerized prescribing by physicians reduces the rate of medication-related errors and systems that automatically page clinicians about serious laboratory abnormalities and remote monitoring of patients in intensive care units also appear promising.
Abstract: Information technology can improve patient safety by preventing errors and facilitating rapid response to adverse events. Computerized prescribing by physicians reduces the rate of medication-related errors. Systems that automatically page clinicians about serious laboratory abnormalities and remote monitoring of patients in intensive care units also appear promising.
TL;DR: Un instrumento util para los comites de seguridad de medicamentos de los hospitales that pretendan establecer programas de notificacion internos, para identificar los fallos in el sistema de utilizacion de medicamentsos and adoptar medidas efectivas de reduccion de errores de medicacion.
Abstract: Objetivo: Elaborar una terminologia y una taxonomia de los errores de medicacion que permitan estandarizar su deteccion, analisis, clasificacion y registro. Material y metodos: Se establecio un grupo de trabajo en el que participaron profesionales de cuatro hospitales de diferentes caracteristicas. La taxonomia se valido mediante el analisis cualitativo de 423 errores de medicacion recogidos en los hospitales participantes. Resultados: Se presenta un documento que incluye una terminologia y una taxonomia para la clasificacion de los errores de medicacion. Conclusion: El documento elaborado facilitara el analisis de la informacion sobre incidentes por medicamentos y permitira efectuar comparaciones entre los datos procedentes de distintos ambitos y centros. Ademas es un instrumento util para los comites de seguridad de medicamentos de los hospitales que pretendan establecer programas de notificacion internos, para identificar los fallos en el sistema de utilizacion de medicamentos y adoptar medidas efectivas de reduccion de errores de medicacion.
TL;DR: The proportion of medication errors in a tertiary hospital, global and for each delivery medication system is estimated, to describe the error types and the implied medications, and to analyze the factors associated to the same ones.
Abstract: Objective: To estimate the proportion of medication errors in a tertiary hospital, global and for each delivery medication system, to describe the error types and the implied medications, and to analyze the factors associated to the same ones. Methods: Errors were identified from direct observation of 2,242 opportunities for error (administered doses or prescribed doses not given) by 6 couples of observers. Delivery medication systems were stock in ward, unit dose with electronic prescription and unit dose with computerized transcription. Logistic regression was used to evaluate the association between errors and certain factors. Results: The medication error rate was of 7.2% (CI 95%: 6.1-8.3), and 4.4% (CI 95%: 3.6-5.3) of them reached the patient. For delivery systems, the error rate was of 9.5% (CI 95%: 7.4-11.9) for stock in ward, 7.8% (CI 95%: 5.9-10.0) for electronic prescription and 4.7% (CI 95%: 3.4-6.4) for computerized transcription. The highest error frequency was observed in the administration phase (58.4%) and the omitted dose was the most prevalent error (31.7%). The error rate was associated to the pharmacotherapeutic process, the schedule of administration and the unit of hospitalization. Conclusions: In one of each 14 opportunities for error a medication error takes place. The different delivery medication systems have different error rates.
TL;DR: Most of the MICUs in the state have changed their practices in controlling and monitoring prehospital medication storage temperature, demonstrating a positive impact from previous research.
Abstract: Previously the authors showed that prehospital medications were stored outside their recommended temperature range. In response, the state office of emergency medical services (EMS) issued regulations regarding temperature control and monitoring of prehospital medications. Objective: To determine the impact of previous research (on medication storage conditions) on current practices among the mobile intensive care units (MICUs) within the state. Methods: A statewide, structured telephone survey of MICU directors was conducted between April and December 2000. Questions focused on changes in storage and monitoring practices (including modifications to vehicles, medication boxes, and the use of temperature monitoring devices) since the authors' previous research. Results: Thirty-three of 35 (94%) programs (100 vehicles) participated in the survey. Eighty-five percent changed their practices since the research five years ago. Of the five that did not change, three already had temperature control measures in p...
TL;DR: Investigation of whether hemoglobin, hematocrit, and tome from kidney transplantation influence results obtained using the immune-enzymatic technique renders enzyme immunoassay a good alternative for the measurement of sirolimus levels in whole blood finding its correlation with chromatography is acceptable.
Abstract: Objective: To compare sirolimus levels measured in whole blood using two analytical techniques: high-resolution liquid chromatography and microparticle enzyme immunoassay, and to evaluate whether hemoglobin, hematocrit, and tome from kidney transplantation influence results obtained using the immune-enzymatic technique. Method: A retrospective, observational study in which all transplanted patients with at least one measurement of sirolimus levels using high-resolution liquid chromatography or microparticle enzyme immunoassay from October 2004 to May 2005 were consecutively included. For statistical comparisons simple linear regression, ANCOVA, intra-class correlation coefficient, and the method of agreement limits were all used. Results: Ninety-one patients were assessed for a total of 307 measurements (median: 2, inter-quartile range: 1-4, range: 1-15) of sirolimus levels. The straight-line equation using the linear regression analysis was as follows: MEIA = 0.70 (95% CI: 0.39- 1.01) + 1.14 (95% CI: 1.10-1.17) x HPLC/UV. The intra-class correlation coefficient between both measurements was 0.955 (95% CI 0.944-0.964). Mean overestimation using enzyme immunoassay was 24.8% ± 19.4%. Difference in means between both measurements was 1.9 ± 1.3 ng/mL. Agreement limits were established between –0.8 ng/mL (95% CI: -1.05; -0.55) and +4.6 ng/mL (95% CI: 4.35; 4.85). Factors such as post-transplant time, hemoglobin, and hematocrit did not influence overestimates obtained using enzyme immunoassays. These results were not influenced by non-independence in measurements. Conclusions: Despite enzyme immunoassay overestimates in establishing sirolimus levels in whole blood, its correlation with chromatography is acceptable. Added to its benefits versus chromatographic techniques, this renders enzyme immunoassay a good alternative for the measurement of sirolimus levels in whole blood.