OBJECTIVES:To investigate the prevalence of potential drug interactions at the intensive care unit of a university hospital in Brazil and to analyze their clinical significance.METHODS:This cross‐sectional retrospective study included 299 patients who had been hospitalized in the intensive care unit of the hospital. The drugs administered during the first 24 hours of hospitalization, in the 50th length‐of‐stay percentile and at the time of discharge were analyzed to identify potential drug‐drug and drug‐enteral nutrition interactions using DRUG‐REAX® software. The drugs were classified according to the anatomical therapeutic chemical classification.RESULTS:The median number of medications per patient was smaller at the time of discharge than in the 50th length‐of‐stay percentile and in the first 24 hours of hospitalization. There was a 70% prevalence of potential drug interactions at the intensive care unit at the studied time points of hospitalization. Most of the drug interactions were either severe or moderate, and the scientific evidence for the interactions was, in general, either good or excellent. Pharmacodynamic interactions presented a subtle predominance in relation to pharmacokinetic interactions. The occurrence of potential drug interactions was associated with the number of medications administered and the length of stay. Medications that induced cytochrome P450, drugs that prolong the QT interval and cardiovascular drugs were pharmacotherapy factors associated with potential drug interactions.CONCLUSION:The study showed that potential drug interactions were prevalent in the intensive care unit due to the complexity of the pharmacotherapies administered. The interactions were associated with the number of drugs, the length of stay and the characteristics of the administered medications.

Objective: To evaluate the perception of the safety climate of nursing professionals working in the medical and surgical clinics of a teaching hospital. Methods: A cross-sectional, descriptive study using a quantitative approach. We used the Safety Attitudes Questionnaire (SAQ) -Short A satisfação no trabalho foi demonstrada por todos os profissionais, com escores acima de 75, enquanto o domínio Percepção da Gerência apresentou valores mais baixos. Conclusão: A satisfação do profissional, o diálogo e o suporte à equipe por parte da administração são essenciais para a garantia da segurança do paciente. Conhecer a percepção dos profissionais de enfermagem sobre o clima de segurança contribui para a melhoria do cuidado em saúde e para a redução dos riscos ao paciente. Descritores: Percepção; Cultura organizacional; Gerenciamento de segurança RESUMEN Objetivo: Evaluar la percepción del clima de seguridad de los profesionales de enfermería que actúan en las clínicas médicas y quirúrgicas de un Hospital de Enseñanza. Métodos: Estudio transversal, descriptivo y con abordaje cuantitativo. Fue utilizado el Safety Attitudes Questionnaire (SAQ) -Short Form 2006, traducido para la lengua portuguesa. Resultados: La percepción del clima de seguridad de los profesionales varió conforme el género, la clínica, la categoría profesional y el tiempo de actuación. La satisfacción en el trabajo fue demostrada por todos los profesionales, con scores arriba de 75, en cuanto que el dominio Percepción de la Gerencia presentó valores más bajos. Conclusión: La satisfacción del profesional, el diálogo y el soporte al equipo por parte de la administración son esenciales para la garantía de la seguridad del paciente. Conocer la percepción de los profesionales de enfermería sobre el clima de seguridad contribuye para la mejoría del cuidado en salud y para la reducción de los riesgos del paciente.

This exploratory study analyzed the medication preparation and administration process in medical-clinical units at four Brazilian hospitals located in the Southeast, Central-West and Northeast, identified problems that can contribute to the occurrence of medication errors and proposed improvement measures. Data were collected through non-participant and direct observation of nursing professionals' activities during one week. The results revealed the following main problems: the environment in Hospital B; preparation errors related to technique and anticipated medication preparation in C and D; technical, communication and patient identification mistakes in Hospital A. Suggestions to achieve greater quality and safety in patient care include the constitution of a multidisciplinary commission to evaluate the system, nursing discussion groups, environmental improvements, permanent courses and training and actual presence of a nurse during the process.

This study's objective was to compare two types of voluntary incident reporting methods that affect patient safety, handwritten (HR) and computerized (CR), in relation to the number of reports, type of incident reported the individual submitting the report, and quality of reports. This was a descriptive, retrospective and cross-sectional study. CR were more frequent than HR (61.2% vs. 38.6%) among the 1,089 reports analyzed and were submitted every day of the month, while HR were submitted only on weekdays. The highest number of reports referred to medication, followed by problems related to medical-hospital material and the professional who most frequently submitted reports were nurses in both cases. Overall CR presented higher quality than HR (86.1% vs. 61.7%); 36.8% of HR were illegible, a problem that was eliminated in CR. Therefore, the use of computerized incident reporting in hospitals favors qualified voluntary reports, increasing patient safety.

Adverse drug reactions of clinical significance were the most frequent ADEs in the ICU studied, which reduces patient safety. The number of ADEs related to drug interactions was small, suggesting that clinical manifestations of drug interactions that harm patients are not frequent in ICUs.

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This study analyzed the causes, types, administrative measures taken and suggestions concerning medication errors according to the perspective of professionals involved with the medication systems in four Brazilian hospitals. It is an exploratory, survey-type, multicentric study. The sample consisted of professionals from the medical clinic and pharmacy in the above-mentioned hospitals. Semistructured interviews were used for data collection. Results showed that the most frequently error types mentioned by the professionals were related to medication ordering/transcription. Lack of attention, individual mistakes and problems in service management were the major causes of errors. Reports were the main measures taken in view of errors, and changes in individual attitudes were the most frequently mentioned form to prevent them.

Objective:to assess the situation of nursing education and to analyze the extent to which baccalaureate level nursing education programs in Latin America and the Caribbean are preparing graduates to contribute to the achievement of Universal Health.Method:quantitative, descriptive/exploratory, cross-sectional study carried out in 25 countries. Results:a total of 246 nursing schools participated in the study. Faculty with doctoral level degrees totaled 31.3%, without Brazil this is reduced to 8.3%. The ratio of clinical experiences in primary health care services to hospital-based services was 0.63, indicating that students receive more clinical experiences in hospital settings. The results suggested a need for improvement in internet access; information technology; accessibility for the disabled; program, faculty and student evaluation; and teaching/learning methods. Conclusion:there is heterogeneity in nursing education in Latin America and the Caribbean. The nursing curricula generally includes the principles and values of Universal Health and primary health care, as well as those principles underpinning transformative education modalities such as critical and complex thinking development, problem-solving, evidence-based clinical decision-making, and lifelong learning. However, there is a need to promote a paradigm shift in nursing education to include more training in primary health care.