Conclusion This study systematically and rigorously identified a set of 31 items which are important for assessing pharmaceutical complexity. This information can then be used for the development and refinement of future and current pharmaceutical complexity screening tools that can aid more efficient targeting of hospital clinical pharmacy services.
BackgroundSurgical patients are especially susceptible to nutritional disorders; additionally an adequate nutritional status is important in achieving prompt recovery.PurposeTo describe and analyse possible shortcomings related to nutritional status of surgical patients associated with an inadequate prescription of parenteral nutrition (PN).Material and methodsA prospective, observational study, lasting two months, of post-surgical patients in a third level hospital with PN support.Estimated calorie requirements (CR) of surgical patients were calculated. The Harris-Benedict formula was the method used to evaluate CR taking into account the degree of metabolic stress in each surgical patient.Data were collected from the medical history of each patient: age, diagnosis, duration of PN support, glycaemia, electrolytes, total proteins and other haematological parameters.An assessment was made of how many blood tests were requested for every patient, at the beginning, during and at the end of parenteral support.ResultsA total of 75 patients were studied. In 19.2% of cases the CR were successfully supplied. In 72.6% of cases the prescribed caloric intake was insufficient compared to their estimated CR. In the remaining 8.2% of cases the caloric intake exceeded their estimated CR.23.2% of the patients studied were obese. In 76.5% of them, the prescribed caloric intake differed from the estimated CR, despite the body weight calculation being adjusted for these patients.ConclusionOur study showed that 80.8% of patients were not given sufficient nutritional support, missing their estimated CR. It shows the lack of a structured protocol to addresses the nutritional assessment in surgical patients.References and/or AcknowledgementsKeith JN. Bedside nutrition assessment past, present, and future: a review of the subjective global assessment. Nutr Clin Pract 2008;23(4):410–16Martins CP, Correia JR, Do Amaral TF. Undernutrition risk screening and length of stay of hospitalized elderly. J Nutr Elder 2005;25(2):5–21No conflict of interest.
BackgroundThe cytostatic unit is a critical area in a hospital, therefore drug-related mistakes should be analysed in order to increase safety and effectiveness in patients treated with chemotherapy.PurposeTo evaluate drug-related mistakes during transcription, preparation or administration of cytostatics.Material and methodsProspective study, two months duration, in which every member of staff involved in the validation (pharmacists), preparation for compounding, compounding and administration of cytostatics (nurses) reported any mistake found, including category of mistake, date and who detected it.Results73 drug-related mistakes were recorded at the cytostatic unit: prescription mistakes (28.3%), transcription mistakes (39.3%), compounding mistakes (16.6%), pre-compounding mistakes (15.8%).Of them, 60.3% were category A, 25.1% category B, 5.1% category C and 9.5% category D. Category A was defined as circumstances or incidents able to end in a mistake, B, there was a mistake but it did not reach the patient, C, the mistake reached the patient but it did not cause any damage, and D, although it caused no damage, monitoring and/or intervention was needed.A total of 20.6% mistakes were reported by the pharmacist, 30% by nurses in charge of compounding, 32.1% by nurses in charge of preparation, 5.8% by staff nurses, and 11.5% by nurses in charge of administration.ConclusionIt is vital to ensure a system of safe validation and be sure to avoid any mistakes that could reach the patient in the case of chemotherapy. Cytostatics have a narrow therapeutic range, so therefore minimal mistakes could end in fatal consequences.References and/or acknowledgementsCytostatic unit of a tertiary hospital.No conflict of interest.
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