RESUMO
PURPOSE: This article presents a summary of recent advances, including tools and interventions, that are designed to improve drug safety for patients in critical care settings, particularly those undergoing anesthesia and surgery. PRINCIPAL FINDINGS: Medication error remains a leading cause of adverse events among patients undergoing anesthesia. Misidentification of ampoules, vials, and syringes is a common source of error. Systems are now being engineered to reduce the likelihood of medication misidentification through approaches such as revision of standards for labelling of drug ampoules and vials and the development of bar code systems that allow "double checking" or drug verification in the operating room. Also, efforts are being made to improve medication reconciliation, a process for accurately communicating a patient's medication information during transitions from one healthcare setting to another. Finally, the opportunity exists for anesthesiologists to increase awareness about the rising problem of opioid addiction in patients for whom typical doses are initially prescribed for appropriate indications such as postoperative pain. CONCLUSIONS: There is a need to improve drug delivery systems in complex critical care environments, particularly the operating room. Anesthesiologists must continue to play a leading role in promoting drug safety in these environments.
Assuntos
Anestesia/normas , Anestesiologia/normas , Erros de Medicação/prevenção & controle , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Anestesia/efeitos adversos , Anestesiologia/métodos , Cuidados Críticos/métodos , Cuidados Críticos/normas , Relação Dose-Resposta a Droga , Rotulagem de Medicamentos , Processamento Eletrônico de Dados , Humanos , Reconciliação de Medicamentos/normas , Sistemas de Medicação no Hospital/normas , Salas Cirúrgicas/normas , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Dor Pós-Operatória/tratamento farmacológicoRESUMO
The purpose of this article is to provide an update on the status of automated identification (e.g., bar coding) of pharmaceutical products manufactured for distribution within Canada.
Assuntos
Processamento Eletrônico de Dados/normas , Relações Interinstitucionais , Erros Médicos/prevenção & controle , Serviço de Farmácia Hospitalar/normas , Canadá , Comportamento Cooperativo , Humanos , Sistemas de Identificação de Pacientes , Serviço de Farmácia Hospitalar/organização & administração , Gestão da SegurançaRESUMO
The Canadian Association of Paediatric Health Centres (CAPHC) and the Institute for Safe Medication Practices Canada (ISMP Canada) are working collaboratively to enhance the safety of pediatric medication use. Eleven CAPHC member organizations submitted data on more than 4,000 medication incidents to ISMP Canada for the period October 2005 to June 2008, 305 of which were reported as resulting in harm. From this, the top five drugs causing harm through medication error and contributing factors to the incidents were identified. In this article, we intend to inform critical care practitioners of the medication incident analyses and the collaborative pediatric patient safety initiatives underway.
