RESUMO
OBJECTIVES: The objective of this work is to describe the interest of developing a simulation for the evaluation and improvement of practices through the realization of a horror week in a cytotoxic preparation unit. METHODS: The simulation was divided into five days, each corresponding to a step in the cytotoxic circuit. Five errors per day were produced and presented to the team in a dedicated room. An observation form was used to collect the errors identified by each person. A satisfaction questionnaire was distributed and a collective debriefing took place remotely. RESULTS: The average number of errors identified per day was 3.8. The least common errors were reversal of patient height and weight, overloading of the sterilization basket, failure to follow dressing rules in the controlled area, absence of the temperature-monitoring disk, and absence of an opaque bag for photosensitive chemotherapy. The perceived level of difficulty was 3.33/5 and the organization was satisfactory to all participants. CONCLUSIONS: Horror Week achieved its objectives by raising awareness among professionals of the risks of the chemotherapy circuit. The errors that were found to be the least significant allowed us to develop priority areas for ongoing training for our unit.
RESUMO
OBJECTIVES: The aim of this study was to determine the effect of pharmacists' interventions (PI) on the potential clinical impact of medication errors, including the lack of therapeutic optimisation of patients with cardiologic diseases, such as heart failure and acute coronary syndrome). METHODS: This was an observational, prospective study conducted in the cardiology department of a French university hospital centre for a duration of 9 months. All prescriptions were analysed and PI were registered for clinical rating by pharmacists and cardiologist. RESULTS: A total of 532 PI cases were recorded in 339 patients, with a mean of 1.57 (±1.04) PI. The PI acceptance rate was 98.1%. "Dose adjustment" and "introduction therapy" were the most common interventions and represented 38.0% and 32.9%, respectively, of all PI. Statins were the most frequently involved drugs (18.1%), followed by ACE (Angiotensin Converting Enzyme) inhibitors (10.9%) and antiplatelet agents (9.3%). Moreover, 13.8% of PI potentially avoided a severe or very severe clinical impact (n = 71) and 38.6% had a significant impact altering the quality of life (n = 198). There was no significant difference between the average score performed by the clinical pharmacist included in the cardiology team and the one obtained by the cardiologist (P = .797). In contrast, a significant difference was observed for the average score established by the pharmacist localised in central pharmacy versus the rating of the cardiologist (P < .001). CONCLUSIONS: The collaboration between clinical pharmacists and cardiologists in the medical units seems to be beneficial to the quality of prescriptions, including the implementation of recommendations. The good rate of PI acceptance and the similar rating with the cardiologist show that there is a change in perspective of the pharmacist, being closer to the clinical reality.