RESUMO:O estudo objetivou identificar a frequência dos erros que ocorrem no preparo de medicamentos intravenosos.Pesquisa transversal de natureza observacional,em três unidades de um hospital. Observaram-se 365 doses de medicamentos intravenosos preparadas por 35 técnicos de enfermagem. A coleta de dados ocorreu entre janeiro e fevereiro de 2008. Encontraram-se taxas de erros acima de 70,00% em todas as unidades. Os erros foram agrupados nas categorias: troca de agulhas, desinfecção de ampolas, limpeza da bancada e hora e dose erradas. As taxas de erro foram superiores a 50,00% em todas as categorias, com exceção de dose errada (6,58%). A segurança microbiológica do procedimento pode ter sido afetada, aumentando a chance de dano ao paciente, em caso de contaminação da solução. O preparo na hora errada, com antecedência de uma hora, ocorreu com tenoxicam e dipirona. A estabilidade dos medicamentos pode ter sido comprometida, causando mudanças no resultado terapêutico esperado, podendo ocorrer consequências indesejáveis aos pacientes. DESCRITORES: Erros de medicação. Enfermagem. Medidas de segurança. PATIENT SAFETY: ANALYSING INTRAVENOUS MEDICATION PREPARATION IN A SENTINEL NETWORK HOSPITAL IN BRAZILABSTRACT: This study aimed to identify the frequency of errors occurring in intravenous medication preparation and to discuss the possible consequences of these errors to patients. This cross-sectional, observational survey was carried out in three units of one hospital, observing 365 intravenous drug doses prepared by 35 technicians. Data was collected in January and February of 2008. Errors rates above 70.00% were found in all units. The errors were grouped into the categories: needle exchange, ampoule disinfection, cleaning the countertop, wrong time, and wrong dose. The error rates were higher than 50.00% in all categories, except for wrong dose (6.58%). The microbiological safety of the procedure may have been affected, increasing the chance of patient harm in cases of solution contamination. Preparation at the wrong time, applying an hour early, occurred with tenoxicam and dipyrone. The stability of the medication may have been compromised, causing changes to the expected therapeutic results, opening further possibilty for undesirable consequences for patients. DESCRITORS: Medication errors. Nursing. Security measures. LA SEGURIDAD DEL PACIENTE: ANÁLISIS DE LA PREPARACIÓN DE MEDICAMENTOS INTRAVENOSOS EN EL HOSPITAL DE LA RED SENTINELARESUMEN: La investigación tubo como objetivo identificar el tipo y frecuencia de los errores en la preparación de medicamentos intravenosos. Se trata de una investigación observacional transversal, en tres unidades de un hospital. Se observaron 365 dosis de medicamentos por vía intravenosa preparados por 35 técnicos de enfermería. Los datos se recolectaron de enero a febrero de 2008. Se encontraron tasas de errores en todos los sectores, por encima de 70,00%. Los errores se agruparon en las siguientes categorías: cambio de jeringas, desinfección de las ampollas, higiene de la encimer...
ABSTRACT:The aim of the study was to identify the types and frequency of errors during the administration of intravenous medication. A Cross-sectional, observational study was carried out in three units of a hospital. Observations were conducted on 367 doses of intravenous medication, prepared by 35 nurse technicians. Data collection took place between January and August of 2008. Errors were grouped in the following categories: medication; patient; route; dosage; phlebitis check and catheter permeability. Results showed error rates present in all categories and of above 80% in the following: fail to check medication; fail to check catheter permeability; fail to check phlebitis presence. There were no errors related to route and dosage. Delayed medication in 69.75% of the doses possibly affected the expected therapeutic results of sodium ampicillin, furosemide and tenoxicam. The high error rates may have caused changes in the expected therapeutic result, giving chance for undesirable consequences for the patients
Objective: To conduct a benchmarking comparison of the composites of patient safety culture based on the evaluation of Brazilian and Portuguese nurses working in university hospitals. Method: Quantitative, cross-sectional, comparative survey. Data collected between April and December 2014, in two teaching hospitals, applying the instrument Hospital Survey on Patient Safety Culture, in the versions translated and adapted to the countries. Results: 762 nurses distributed in four services participated in the study, 195 Brazilians and 567 Portuguese. Seven of the 12 composites of safety culture showed significant differences between hospitals. The highlights were those related to: “management support for patient safety” (±17); “handoffs and transitions” (±15); “teamwork across units” (±14); and “overall perceptions of patient safety” (±10). Conclusion: The dimension that had the highest significant difference between the studied institutions was “management support for patient safety”. These data may support the managers of the study hospitals, enabling continuous improvements and advancements.
Objective: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. Method: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. Results: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). Conclusion: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital’s services, serving as a warning and assisting in the services’ improvement.
RESUMO:Estudo cujo objetivo foi identificar e analisar os fatores de risco para a ocorrência de erros no preparo de medicamentos endovenosos pela enfermagem e propor um checklist para promover maior segurança no preparo. Foram selecionados treze artigos das bases de dados LILACS, BDENF, SciELO e MEDLINE/PUBMED entre os períodos de 2004 a 2013. Destacaram-se quatro principais categorias: fatores psicológicos e sobrecarga de trabalho, erros relacionados ao ambiente de preparo, déficit de atualização em educação em saúde e erros relacionados à técnica de preparo. Conclui-se que a técnica de preparo foi o fator de risco mais citado nos estudos, seguido das categorias déficit de atualização em educação e saúde, ambientes de preparo e sobrecarga de trabalho associada a fatores psicológicos. Baseado nas dificuldades identificadas nas categorias encontradas foi elaborado um checklist relacionado à técnica de preparo, visando minimizar erros e garantir a qualidade da assistência e segurança do paciente. DESCRITORES: FACTORES DE RIESGO PARA OCURRENCIA DE ERRORES EN LA PREPARACIÓN DE MEDICAMENTOS ENDOVENOSOS: UNA REVISIÓN INTEGRATIVA RESUMEN:Estudio cuyo objetivo fue identificar y analizar los factores de riesgo para la ocurrencia de errores en la preparación de medicamentos endovenosos por la enfermería y proponer un checklist para promover más seguridad en esa preparación. Fueron seleccionados trece artículos de las bases de datos LILACS, BDENF, SciELO y MEDLINE/PUBMED entre los periodos de 2004 a 2013. Se destacaron cuatro principales categorías: factores psicológicos y sobrecarga de trabajo, errores asociados al ambiente de preparación, déficit de actualización en educación en salud y errores referentes a la técnica de preparación. Se concluye que la técnica de preparación fue el factor de riesgo más mencionado en los estudios, seguido de las categorías déficit de actualización en educación y salud, ambientes de preparación y sobrecarga de trabajo asociada a factores psicológicos. Con base en las dificultades identificadas en las categorías halladas, fue elaborado un checklist para la técnica de preparación, con la finalidad de minimizar errores y garantizar la cualidad de la asistencia y seguridad del paciente. DESCRIPTORES: RISK FACTORS FOR THE OCCURRENCE OF ERRORS IN THE PREPARATION OF INTRAVENOUS MEDICATIONS: AN INTEGRATIVE REVIEWABSTRACT: This study aimed to identify and analyze the risk factors for the occurrence of errors in the preparation of intravenous medications by nurses, and to propose a checklist in order to promote greater safety in the preparation. A total of 13 articles were selected from the LILACS, BDENF, SciELO and MEDLINE/PUBMED databases, published in the period 2004 -2013. Four main categories stood out: psychological factors and work overload, errors related to the preparation environment, lack of updating in health education, and errors related to the preparation technique. It is concluded that the preparation technique was the most-mentioned risk factor in the studies, followed by the categ...
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