A Pediatric Intensive Care Checklist for Interprofessional Rounds: The R-PICniC Study.

BACKGROUND: The use of checklists in the pediatric intensive care unit can help improve the quality of care and patient safety. OBJECTIVES: To build and validate a checklist for use in interprofessional rounds in a pediatric intensive care unit. METHODS: This methodological study was conducted in a 20-bed pediatric intensive care unit serving children up to 14 years old. A checklist prototype was constructed through review of the literature and achievement of consensus among the professionals providing care in the unit. Content validation was performed using a modified Delphi technique involving specialists with more than 5 years of experience in pediatric intensive care, methodological studies, and patient safety. Content validity ratios were calculated for the elements of the checklist, which were considered valid when they reached values greater than 0.78. The checklist was tested for usability, application time, and effects on patient care, and feedback was obtained from potential users. RESULTS: Before content validation, the checklist contained 11 domains, 32 items, and 6 daily goals. The invitation to validate content was sent to 86 specialists, and content validity was achieved after 2 rounds of evaluation, with the checklist elements having content validity ratios ranging from 0.94 to 0.97. The mean application time of the checklist was 5 minutes. The final version consisted of 11 domains, 33 items, and 8 daily goals. CONCLUSIONS: This study resulted in a useful and valid instrument for application in interprofessional rounds that was tailored to the needs of local health care professionals.

Risk factors for peripheral intravenous catheter-related phlebitis in adult patients.

OBJECTIVE: To identify risk factors for peripheral intravenous catheter-related phlebitis in adult patients. METHOD: This is a post hoc analysis of a randomized clinical trial, totaling 1,319 patients. Demographic and clinical variables related to therapy and phlebitis were investigated. For data analysis, frequencies, measures of central tendency and dispersion were calculated, and Pearson's chi-square test and Fisher's exact test were used, with logistic regression, ROC curve, and Odds Ratio calculation (95% confidence interval; 5% significance level) being implemented. RESULTS: Of the 1,319 participants, 80 (6.1%) developed phlebitis. The following were associated with the occurrence of phlebitis: reduced mobility (p = 0.015), family history of deep vein thrombosis (p = 0.05), catheterization of veins on the back of the hand (p = 0.012), pain (p < 0.01), Amoxicillin-Potassium Clavulanate (p = 0.015), and Omeprazole Sodium (p = 0.029). CONCLUSION: Risk factors for phlebitis involved intrinsic and extrinsic factors to the patient, indicating preventive nursing interventions such as promoting patient mobility, not catheterizing veins in the dorsal arch of the hand, cautious infusion of risk drugs, and valuing pain complaints.

Start-up delay in syringe infusion pumps with different rates and priming techniques of intravenoust sets.

OBJECTIVE: To investigate infusion pumps start-up delay according to different brands of infusion pumps, flow rates and intravenous sets priming techniques. METHOD: The experimental study simulated clinical practice under controlled conditions, using a 50 mL syringe with NaCl 0.9% solution, two syringe infusion pumps (A and B), six rates (0.3, 0.5, 1.0, 5, 10 and 20 mL/h), two purging techniques (manually or infusion pump's electronic bolus). Data were analyzed according to mean, standard deviation, Student's t and ANOVA tests (p<0.05). RESULTS: The start-up delay was greater in low rates regardless the priming technique. The electronic bolus increased the infusion pump A accuracy at 0.3mL/h (p=0.010), 0.5 mL/h (p=0.002) and 1.0mL/h (p=0.004). Pump's accuracy in all studied rates and manual IV sets filling was similar. CONCLUSION: In low infusion rates the start-up delay was greater despite the infusion pump brand and electronic bolus improved pumps accuracy.

The complexity of having a child with a congenital heart defect in a developing country: A qualitative study of parental needs.

PURPOSE: To explore parental needs related to their experiences of living with a child with congenital heart defect (CHD) since the diagnosis. DESIGN AND METHODS: An interpretative qualitative study developed with nine parents of children between the ages of five months and 11 years diagnosed with CHD. Interviews were conducted at an ambulatory pediatric cardiology centre. Data were analyzed using inductive thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) was followed for quality reporting. This research was approved by a research committee. RESULTS: One central theme emerged, namely 'A desire to feel safe in dealing with the demands of CHD,' along with two main themes. The first is 'Looking for effective relations with healthcare professionals and health care systems' which encompasses three types of need: (1) need for continuous, clear and accurate information; (2) need for resolution and the support of services such as the public health care system and social services; (3) need for trust in health care professionals. The second theme is 'Looking for balance in daily life' with two main needs: (1) maintain family functioning and (2) learn to deal with the child and CHD. CONCLUSION: The main parental needs are related to their interactions with healthcare professionals and healthcare systems, highlighted by a need for information and trust relationships to feel safe in their daily lives. PRACTICE IMPLICATIONS: Our results imply rethinking the nurse presence in ambulatory care, implementation of a family-centered care approach and addressing the diverse and multifaceted experiences and needs of parents and children with CHD in different health care contexts.

Impact of different syringe pumps on red cells during paediatric simulated transfusion.

BACKGROUND: Critically ill patients frequently need blood transfusions. For safety, blood must be delivered via syringe infusion pumps, yet this can cause red cell damage and increase the rate of haemolysis. AIMS AND OBJECTIVES: To evaluate biochemical and haemolytic markers of red blood cells transfused in three different types of syringe infusion pumps at two different infusion rates (10 and 100 mL/h). DESIGN AND METHODS: A lab-based study using aliquots of 16 red blood cell bags was undertaken. Haemolysis markers (total haemoglobin [g/dL], haematocrit [%], free haemoglobin [g/dL], potassium [mmol/L], lactate dehydrogenase [U/L], osmolality [mOsm/kg], pH, degree of haemolysis [%]) were measured before and after red blood cell infusion and exposure. Three different syringe infusion pumps brands (A, B, and C) were compared at two different infusion rates (10 and 100 mL/h). RESULTS: Total haemoglobin fell significantly in all red blood cell units during manipulation (pre-infusion: 26.44 ± 5.74; post-exposure: 22.62 ± 4.00; P = .026). The degree of haemolysis significantly increased by 40% after manipulation of the red blood cells. Syringe infusion pump A caused a 3-fold increase in potassium levels (3.78 ± 6.10) when compared with B (-0.14 ± 1.46) and C (1.63 ± 1.98) (P = .015). This pump also produced the worst changes, with an increase in free haemoglobin (0.05 ± 0.05; P = .038) and more haemolysis (0.08 ± 0.07; P = .033). There were significant differences and an increase in the degree of haemolysis (P = .004) at the infusion rate of 100 mL/h. CONCLUSIONS: Syringe infusion pumps may cause significant red blood cell damage during infusion, with increases in free haemoglobin, potassium, and the degree of haemolysis. Some pump types, with a cassette mechanism, caused more damage. RELEVANCE TO CLINICAL PRACTICE: In many intensive care units, bedside nurses are able to consider infusion pump choice, and understanding the impact of different pump types on red blood cells during a transfusion provides the nurses with more information to enhance decision-making and improve the quality of the transfusion.

Start-up delay in syringe infusion pumps with different rates and priming techniques of intravenoust sets / Retardo en la puesta en marcha en bombas de infusión de jeringa con diferentes velocidades de infusión y purga del sistema de infusión / Atraso na inicialização em bombas de infusão por seringa com diferentes velocidades de infusão e técnicas de preenchimento do sistema de infusão

ABSTRACT Objective: To investigate infusion pumps start-up delay according to different brands of infusion pumps, flow rates and intravenous sets priming techniques. Method: The experimental study simulated clinical practice under controlled conditions, using a 50 mL syringe with NaCl 0.9% solution, two syringe infusion pumps (A and B), six rates (0.3, 0.5, 1.0, 5, 10 and 20 mL/h), two purging techniques (manually or infusion pump's electronic bolus). Data were analyzed according to mean, standard deviation, Student's t and ANOVA tests (p<0.05). Results: The start-up delay was greater in low rates regardless the priming technique. The electronic bolus increased the infusion pump A accuracy at 0.3mL/h (p=0.010), 0.5 mL/h (p=0.002) and 1.0mL/h (p=0.004). Pump's accuracy in all studied rates and manual IV sets filling was similar. Conclusion: In low infusion rates the start-up delay was greater despite the infusion pump brand and electronic bolus improved pumps accuracy.

RESUMEN Objetivo: El objetivo fue investigar el retraso en la operación de bombas de infusión de acuerdo con diferentes marcas de bombas de infusión, velocidades de infusión y técnicas de purga de lo sistema de infusión. Método: Estudio experimental que simuló la práctica clínica en condiciones controladas con jeringas de 50 mL y solución de NaCl 0,9%, dos bombas de infusión de jeringa (A y B), seis velocidades (0,3; 0,5; 1,0; 5; 10 y 20 mL/h), dos modos de purga (manual o electrónico por la bomba de infusión - bolo). Los datos se analizaron según media, desviación estándar, Test-T y ANOVA (p<0,05). Resultados: El retraso de la operación de las bombas ocurrió en tasas bajas independientemente de la técnica de purga. El modo electrónico aumentó la precisión de la bomba de infusión A en 0,3 mL/h (p=0,010), 0,5 mL/h (p = 0,002) y 1,0 mL/h (p=0,004). Con la técnica manual la precisión fue similar. Conclusión: Los retrasos de operación fueran significantes en bajas velocidades de infusión y el modo electrónico optimizó la precisión.

RESUMO Objetivo: Verificar o atraso de inicialização de bomba de infusão, segundo diferentes marcas de bombas de infusão, velocidades e técnicas de preenchimento do sistema de infusão intravenosa. Método: Estudo experimental que simulou a prática clínica, utilizando seringas de 50 mL com solução de NaCl 0,9%, duas marcas de bombas de infusão por seringa (A e B), seis velocidades (0,3; 0,5; 1,0; 5; 10 e 20 mL/h), dois modos de preenchimento do sistema (manual ou eletrônico pelo modo bolus do equipamento). Os dados foram analisados segundo média, desvio padrão e testes t de Student e ANOVA (p<0,05). Resultados: O atraso na inicialização foi maior em velocidades baixas, independentemente da marca e modo de preenchimento. O preenchimento eletrônico aumentou a acurácia na bomba A em 0,3 mL/h (p=0,010), 0,5 mL/h (p=0,002) e 1,0 mL/h (p=0,004). A acurácia em preenchimento manual foi semelhante. Conclusão: Em baixas velocidades de infusão o atraso de inicialização foi maior e o preenchimento do sistema de infusão pelo modo eletrônico melhorou a acurácia dos equipamentos.

Professor habilitation: the recognition of a trajectory committed to teaching, research, and extension.

OBJECTIVE: to describe faculty member training as a strategy for the development of leaders and the promotion of continuous academic progress in teaching, research, and extension. METHOD: this reflection article presents a history of the highest academic degree obtained in Brazil, describing the characteristics of the competitions and highlighting aspects and activities that show, nowadays, intellectual and scientific maturation. RESULTS: aspiring professors submit their academic trajectory to analysis and judgment by peers, based on strict assessment criteria, to receive a professor habilitation. Its purpose is to promote a moment of analysis of their academic career and to identify the remarkable contribution to the advancement of the university and the country through consolidated and impactful activities. FINAL CONSIDERATIONS: pursuing this highest degree in the Brazilian academic career can be a moment of individual and collective advancement, contributing to the consolidation of areas of knowledge.

Effect of warming and infusion of red blood cell concentrates on markers of haemolysis: An ex vivo simulation study.

BACKGROUND: Transfusion of red blood cell (RBC) concentrates is a common procedure to restore blood volume and tissue oxygen delivery in patients with trauma. Although RBC warmers may prevent hypothermia, some warming or infusion equipment may lead to haemolysis and patient injury. OBJECTIVES: The aim of this study was to test the effect of (i) RBC warming and (ii) administration via manual vs. pump infusion on haemolysis. METHODS: This experimental ex vivo study studied haemolysis markers of RBC injury. The sample consisted of 90 RBC infusions in two simulations, randomly, 45 warmed RBC infusions and 45 nonwarmed RBC infusions, in two or three stages: before the intervention (baseline-warming, N= 45; nonwarming, N= 45), after water bath warming at 42 °C (warmed, N= 45), and then after the warmed or nonwarmed RBCs were infused by manual or pump infusion at a rate of 100 mL/h (infusion-warming, N= 45; nonwarming, N= 45). RESULTS: Warmed RBCs showed significantly lower total haemoglobin (Hb) and haematocrit levels and increase in free Hb levels, haemolysis levels, and lactate dehydrogenase (LDH) activity (all p<0.05) than baseline RBCs. Pump infusion RBCs were associated with reduced total Hb and increased free Hb, haemolysis, and potassium (K) levels (all p<0.05) compared with warmed RBCs. In contrast, manual infusion of warmed RBCs resulted in significantly reduced total Hb levels and increased LDH activity (both <0.05). After infusion, total Hb, free Hb, haematocrit, haemolysis, and LDH values were significantly different for warmed vs. nonwarmed RBCs (p<0.05). CONCLUSIONS: Haemolysis biomarkers increase with RBC warming and infusion, especially when using infusion pumps. Critically ill patients should be carefully monitored for possible complications during and after RBC infusion.

Professor habilitation: the recognition of a trajectory committed to teaching, research, and extension / Livre-docência: o reconhecimento de uma trajetória comprometida com o ensino, pesquisa e extensão

ABSTRACT Objective: to describe faculty member training as a strategy for the development of leaders and the promotion of continuous academic progress in teaching, research, and extension. Method: this reflection article presents a history of the highest academic degree obtained in Brazil, describing the characteristics of the competitions and highlighting aspects and activities that show, nowadays, intellectual and scientific maturation. Results: aspiring professors submit their academic trajectory to analysis and judgment by peers, based on strict assessment criteria, to receive a professor habilitation. Its purpose is to promote a moment of analysis of their academic career and to identify the remarkable contribution to the advancement of the university and the country through consolidated and impactful activities. Final considerations: pursuing this highest degree in the Brazilian academic career can be a moment of individual and collective advancement, contributing to the consolidation of areas of knowledge.

RESUMEN Objetivo: describir la formación de profesores universitarios como una estrategia para el desarrollo de líderes y la promoción del progreso académico continuo en la docencia, investigación y extensión. Método: este artículo de reflexión presenta una historia del más alto grado académico obtenido en Brasil, describiendo características de las competencias y destacando aspectos y actividades que muestran, hoy, maduración intelectual y científica. Resultados: los aspirantes a habilitación a la enseñanza someten su trayectoria académica al análisis y juicio de pares, con base en estrictos criterios de evaluación. Su propósito es promover un momento de análisis de la carrera académica e identificar el aporte notable al avance de la universidad y del país, a través de actividades consolidadas e impactantes. Consideraciones finales: la búsqueda de este grado más alto en la carrera académica brasileña puede ser un momento de avance individual y colectivo, contribuyendo a la consolidación de áreas de conocimiento.

RESUMO Objetivo: descrever a formação do Livre-Docente como estratégia para o desenvolvimento de lideranças e a promoção de contínuo avanço acadêmico no ensino, na pesquisa e na extensão. Método: este artigo de reflexão apresenta histórico da titulação acadêmica mais alta obtida no Brasil, descrevendo características dos concursos e destacando aspectos e atividades que evidenciam, nos dias de hoje, amadurecimento intelectual e científico. Resultados: professores aspirantes à Livre-Docência submetem sua trajetória acadêmica à análise e ao julgamento realizado por pares, com base em rigorosos critérios de avaliação. Tem por finalidade promover um momento de análise da carreira acadêmica e identificar a contribuição marcante para o avanço da universidade e do país, por meio de atividades consolidadas e de impacto. Considerações finais: a busca por esta mais alta titulação da carreira acadêmica brasileira pode constituir momento de avanço individual e coletivo, contribuindo para a consolidação de áreas de conhecimento.

Interrupções de atividades de enfermeiros: contribuições para a segurança do paciente e do profissional / Interrupciones de actividades de los enfermeros: contribuciones para la seguridad del paciente y del profesional / Interruptions of nursing activities: contributions to patient and professional safety

Resumo Objetivo Classificar atividades realizadas por enfermeiros, identificar interrupções e verificar fatores humanos e ambientais associados às interrupções. Métodos Estudo observacional realizado com amostra composta por 25 enfermeiros que trabalham em unidades pediátricas ou de adultos, cirúrgicas ou de terapia intensiva de um hospital universitário. Resultados Observamos 2.295 atividades, a maioria classificada como assistência indireta ao paciente (38,6%) e assistência direta ao paciente (22,5%). Setecentos e dezenove (31,3%) atividades interrompidas foram identificadas, com média de 1,6 interrupções na mesma atividade, totalizando 1.180 interrupções. Houve maior número de interrupções durante o cuidado indireto (44,7%), e suas principais fontes foram equipe de enfermagem (43,3%) e médicos e residentes (16,5%). O número de indivíduos nas unidades (profissionais e familiares/acompanhantes), a proporção de pacientes em alta dependência e o número de profissionais de saúde influenciaram o número de interrupções. Conclusão Houve interrupções em todos os tipos de atividades realizadas pelos enfermeiros, mesmo naquelas caracterizadas como intervenções à beira do leito, o que pode comprometer a segurança do paciente.

Resumen Objetivo Clasificar actividades realizadas por enfermeros, identificar interrupciones y verificar factores humanos y ambientales asociados a las interrupciones. Métodos Estudio observacional realizado con muestra compuesta por 25 enfermeros que trabajan en unidades pediátricas o de adultos, quirúrgicas o de cuidados intensivos de un hospital universitario. Resultados Observamos 2.295 actividades, la mayoría clasificada como atención indirecta al paciente (38,6%) y atención directa al paciente (22,5%). Se identificaron 719 (31,3%) actividades interrumpidas, con un promedio de 1,6 interrupciones de la misma actividad, totalizando 1.180 interrupciones. Hubo mayor número de interrupciones durante el cuidado indirecto (44,7%) y sus principales fuentes fueron el equipo de enfermería (43,3%) y médicos y residentes (16,5%). El número de individuos en las unidades (profesionales y familiares/acompañantes), la proporción de pacientes de alta dependencia y el número de profesionales de la salud influyeron en el número de interrupciones. Conclusión Hubo interrupciones en todos los tipos de actividades realizadas por los enfermeros, inclusive en aquellas caracterizadas como intervenciones a pie de cama, lo que puede comprometer la seguridad del paciente.

Abstract Objective To classify activities performed by nurses, to identify interruptions and to verify human and environmental factors associated with interruptions. Methods Observational study conducted with a sample comprising 25 nurses working in pediatric or adult, surgical or intensive care units of a university hospital. Results We observed 2,295 activities, most of them were classified as indirect patient care (38.6%) and direct patient care (22.5%). Seven hundred and nineteen (31.3%) interrupted activities were identified, with mean of 1.6 interruptions in the same activity, thus totaling 1,180 interruptions. There was greater number of interruptions during the indirect care (44.7%), and their main sources were the nursing (43.3%), and the physicians and residents (16.5%) staffs. The number of individuals in the units (staff and family/visitors), the proportion of patients under high-dependency, the number of healthcare and allied professionals influenced the number of interruptions. Conclusion There were interruptions in all types of activities performed by the nurses, even in those characterized as bedside interventions, which can jeopardize patient safety.

Effects of Blood Transfusion Sets on Red Blood Cell Hemolysis.

This experimental randomized study compared the effects of macrodrop and microdrop blood transfusion sets on red blood cell (RBC) hemolysis. Twenty units of packed RBCs from different donors were infused through 48 infusion sets from 2 manufacturers at infusion rates of 10 and 100 mL/h. Pre- and postinfusion analysis was performed to determine total hemoglobin (g/dL), hematocrit (%), free hemoglobin (g/dL), potassium (mmol/L), haptoglobin (g/L), and degree of hemolysis (%). The results demonstrated that the level of free hemoglobin (P < .001) and degree of hemolysis (P < .001) increased postinfusion. A higher degree of hemolysis was noted when the RBCs were infused at a rate of 10 mL/h through a microdrop blood transfusion set.

[Assertiveness and peripheral intravenous catheters dwell time with ultrasonography-guided insertion in children and adolescents]. / Assertividade e tempo de permanência de cateteres intravenosos periféricos com inserção guiada por ultrassonografia em crianças e adolescentes.

Randomized controlled trial which aimed to verify whether the use of vascular ultrasound (VUS) increases assertiveness in the use of peripheral venous catheter in children, and the catheter dwell time, when compared to traditional puncture. Data were collected after approval of theethical merit. Children and adolescents undergoing VUS-guided peripheral intravenous (GVUS) or puncture guided by clinical assessment of the venous conditions(CG) were included in the study. Significance level was set at p< or =0.05. The sample was composed of 382 punctures, 188 (49.2%) in VUS Gand 194 (50.8%) in CG, performed in 335 children. Assertiveness was found in 73 (71.6%) GVUS catheters and in 84(71.8%) of the CG (p=0.970), and catheter dwell time presented a median of less than one day in both groups (p=0.121), showing nostatistically significant difference. VUS did not significantly influence the results of the dependent variables investigated. ClinicalTrials.govNCT00930254.

Oral care with 0.12% chlorhexidine for the prevention of ventilator-associated pneumonia in critically ill children: randomised, controlled and double blind trial.

PURPOSE: To test the effectiveness of oral care with 0.12% chlorhexidine in decreasing ventilator-associated pneumonia in critically ill children. METHODS: Prospective, randomised, controlled, double-blind clinical trial performed in a paediatric critical care unit at a university hospital. The sample was composed of 96 mechanically ventilated children randomly allocated to the chlorhexidine group (oral care with a toothbrush and an antiseptic gel twice a day) and the placebo group (oral care with a toothbrush and a non-antiseptic gel twice a day). Microbiological analyses of oropharyngeal and tracheal secretions were performed 24, 48 and 96h after intubation. Chi-square, Fischer's exact and Mann-Whitney tests were applied (p≤0.05). RESULTS: The chlorhexidine group was composed of 46 children, and the placebo group consisted of 50 children. Within these samples, 15 (32.6%) children in the chlorhexidine group and 16 (32.0%) children in the placebo group developed ventilator-associated pneumonia (p=0.949). Children in the chlorhexidine group without potentially pathogenic microflora in their oropharynx 24h after mechanical ventilation presented with fewer episodes of ventilator-associated pneumonia (p=0.019). The pathogen colonization profile of children with ventilator-associated pneumonia in the chlorhexidine group included Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. In the placebo group, Pseudomonas aeruginosa and Escherichia coli were the predominant potentially pathogenic microorganisms. The intervention did not influence paediatric intensive care unit mortality (p=0.425), hospital length of stay (p=0.143), or paediatric intensive care unit length of stay (p=0.177). CONCLUSIONS: The use of 0.12% chlorhexidine did not significantly modify the VAP incidence in a sample of mechanically ventilated children.

Oral care and oropharyngeal and tracheal colonization by Gram-negative pathogens in children.

BACKGROUND: Critical care nursing interventions to oral care can reduce microorganisms in the oropharynx available for translocation. OBJECTIVES: To analyse the effect of 0·12% chlorhexidine digluconate on the colonization of oropharyngeal and tracheal secretions by Gram-negative pathogens in mechanically ventilated children. METHODS: A randomized, controlled and double-blinded study was performed in the paediatric intensive care unit (PICU) of a Brazilian university hospital. Exclusion criteria included child age under 28 days, pneumonia diagnosis at admission, use of tracheostomy, PICU length of stay (LOS) less than 48 h and refusal to participate. Children were randomly allocated to the interventional group (IG), in which oral care with chlorhexidine was administered, or to the placebo group (PG), which received oral care without antiseptic use. The data were analysed through Pearson's χ(2) test, Fisher's exact and ANOVA tests with significance levels set at 0·05. RESULTS: The demographic characteristics of the 74 children were not statistically different between groups. No between-group differences in oropharyx colonization by Gram-negative pathogens were identified (p = 0·316). Pathogens were isolated in the tracheal secretions of two (10·0%) children in the PG and four (19·0%) children in the IG (p = 0·355). CONCLUSION: The use of chlorhexidine did not significantly influence the colonization of oropharyngeal and tracheal secretions by Gram-negative pathogens of the studied sample. RELEVANCE TO CLINICAL PRACTICE: This study demonstrated no influence of a specific antiseptic agent on colonization profile of mechanically ventilated children in PICU. Further research in this field is necessary to promote evidence-based nursing practice on oral care of critically ill children.

[Medication errors in pediatrics: analysis of nursing records on the patient chart]. / Erros de medicação e m pediatria: análise da documentação de enfermagem no prontuário do paciente.

Descriptive and correlational study which aimed to verify medication errors through the analyzes of medical charts of children admitted in three pediatric wards of a university hospital. The errors could represent record gaps verified on the care process documentation, that do not compromise the patient safety. In the 68 medical charts 1717 errors were verified, 21.1% of the 8152 drugs doses or solutions ordered during the studied period. More than 13 categories of errors were identified, omission errors (dose or records) were the most frequents (75.7%). The types of errors indicated the need of continuous education and the implementation of management tools that allowed the development of the practice and monitoring results.

Erros de medicação em pediatria: análise da documentação de enfermagem no prontuário do paciente / Medication errors in pediatrics: analysis of nursing records on the patient chart

Estudo descritivo e transversal realizado em três unidades pediátricas de um hospital universitário que objetivou, por meio da análise do prontuário do paciente, identificar erros de medicação. Estes erros podem caracterizar-se como falhas no registro do processo de atendimento, que não chegaram a comprometer a segurança dos pacientes. Nos 68 prontuários investigados identificaram-se 1717 erros de registro, compondo 21,1 por cento das 8152 doses de medicamentos ou soluções prescritas no período investigado. Foram categorizados mais de 13 tipos de erros, destacando-se os de omissão de dose ou de registro da execução da dose (75,7 por cento). Frente aos eventos verificados, sugere-se o desenvolvimento de programas de educação continuada e a criação de ferramentas de gestão da assistência que permitam desenvolver esta prática, monitorando resultados obtidos.