[The role of the cytostatic drugs unit in rationalization of hospital drugs management--the case study and the analysis of drug utilization]. / Znaczenie pracowni leków cytostatycznych w racjonalizacji szpitalnej gospodarki lekami--studium przypadku i analiza uzytkowania leków.

UNLABELLED: Until recently, the cytostatic drugs were being prepared at the Polish hospitals by the nursing staff on hospital wards, however according to the Pharmaceutical Law, preparation of cytostatic drugs, as a pharmaceutical service, should be performed by the pharmacists, who possess appropriate qualifications and experience in working within aseptic conditions and who are trained in professional handling with harmful substances. The aim of this paper has been to assess the impact, which establishment of the cytostatic drugs unit at the hospital pharmacy of the big oncologic hospital, located in southern Poland, had on the overall costs of cytostatic drugs utilization. MATERIAL AND METHODS: The analysis of drugs consumption, as well as determining the size of losses of particular active substances, prepared by the cytostatic drugs unit, have been based on statistical reports, provided by the hospital pharmacy. In order to calculate the level of consumption and losses of active substances in the chemotherapy ward, in framework of the previous modality of function, the estimations have been done, taking into consideration the same needs of particular patients, as those included within reports provided by the pharmacy. The actual prices of drugs from year 2012 have been applied in the assessment of costs of drug utilization. The calculations have been done with Excel and SPSS v.21 software. The methods of descriptive statistics and the comparison of groups, using the Student's t-test for dependent samples have been applied. RESULTS: Due to functioning of the centralized modality of cytostatic drugs preparation within the specialized unit, the decline of overall cytostatic drug consumption, amounting to 9.73% has been observed. The reduction in losses, on stage of preparation of drugs, has been achieved and the share of these losses within overall consumption of drugs has dropped by 77.28%. The dissolution of cytostatic drugs in the cytostatic drugs unit, instead of the chemotherapy ward, allows the hospital to achieve the yearly savings, exceeding PLN 572,276.07. CONCLUSIONS: Establisment of the cytostatic drugs unit, at the hospital pharmacy of the specialist oncologic hospital, not only allowed for increasing quality of pharmacotherapy, but also for substantial savings, when compared with the previously used method of dissolving and preparing cytostatic drugs by the nurses, instantly at the chemotherapy wards.

Tablet-splitting: a common yet not so innocent practice.

AIM: This paper is a report of a study conducted to quantify (i) the mean deviation from theoretical weight and (ii) the mean weight loss, after tablet-splitting with three different, commonly used splitting methods. BACKGROUND: Tablet-splitting is a widespread practice among all sectors of health care for different reasons: it increases dose flexibility, makes tablet parts easier to swallow and allows cost savings for both patients and healthcare providers. However, the tablet parts obtained are often not equal in size, and a substantial amount of tablet can be lost during splitting. METHOD: Five volunteers were asked to mimic the situation in nursing homes and to split eight tablets of different sizes and shapes using three different routine methods: (i) with a splitting device (Pilomat® ), (ii) with scissors for unscored tablets or manual splitting for scored tablets and (iii) with a kitchen knife. Before and after splitting, tablets and tablet parts were weighed using an analytical balance. The data were collected in 2007. RESULTS: For all tablets, method 1 gave a statistically significantly lower mean deviation from theoretical weight. The difference between method 2 and method 3 was not statistically significant. When pooling the different products, method 1 also induced significantly less weight loss than the two other methods. CONCLUSION: Large dose deviations or weight losses can occur while splitting tablets. This could have serious clinical consequences for medications with a narrow therapeutic-toxic range. On the basis of the results in this report, we recommend use of a splitting device when splitting cannot be avoided.

Errors in preparation and administration of intravenous medications in the intensive care unit of a teaching hospital: an observational study.

OBJECTIVE: To determine the frequency of medication errors that occurred during the preparation and administration of IV drugs in an intensive care unit. SETTING: The study was conducted in a 12-bed intensive care unit of one of the largest teaching hospitals in Tehran. DESIGN: Data were collected over 16 randomly selected days at different medication round times, between July and September 2006. A trained observer accompanied nurses during intravenous (IV) drug rounds. Medication errors were recorded during the observation times of IV drug administration and preparation. Drugs with the highest rate of use in the intensive care unit (ICU) were selected. Details of the process of preparation and administration of the selected drugs were compared to an informed checklist which was prepared using reference books and manufacturers' instructions. RESULTS: We observed a total of 524 preparations and administrations. The calculated number of opportunities for error was 4040. The number of errors identified were 380/4040 (9.4%). Of those, 33.6% were related to the preparation process and 66.4% to the administration process. The most common type of error (43.4%) was the injection of bolus doses faster than the recommended rate. Amikacin was involved in the highest rate of error (11%) among all the selected medications. It was found that the IV rounds conducted at 9:a.m. had the highest rate of error (19.8%). No significant correlation was found between the rate of error and the nurses' age, sex, qualification, work experience, marital status, and type of working contract (permanent or temporary). CONCLUSIONS: Since our system is devoid of a well-organized reporting system, errors are not detected and consequently not prevented. Administrators need to take the initiative of developing systems that guarantee safe medication administration.

The effect of information provision on reduction of errors in intravenous drug preparation and administration by nurses in ICU and surgical wards.

Malpractice in preparation and administration of intravenous (IV) medications has been reported frequently. Inadequate knowledge of nurses has been reported as a cause of such errors. We aimed to evaluate the role of nurses' education via installation of wall posters and giving informative pamphlets in reducing the errors in preparation and administration of intravenous drugs in 2 wards (ICU and surgery) of a teaching hospital in Tehran, Iran. A trained observer stationed in 2 wards in different work shifts. He recorded the nurses' practice regarding the preparation and administration of IV drugs and scored them before and after the education process. 400 observations were evaluated. Of them, 200 were related to before education and 200 were related to after education. On a 0-10 quality scale, mean ± SD scores of before and after education were determined. Mean ± SD scores of before and after education at the 2 wards were 4.51 (± 1.24) and 6.15 (± 1.23) respectively. There was a significant difference between the scores before and after intervention in ICU (P<0.001), surgery (P<0.001), and total two wards (P<0.001). Nurses' education by using wall poster and informative pamphlets regarding the correct preparation and administration of IV drugs can reduce the number of errors.

Errores en la preparación y administración de medicamentos: una revisión integradora de la Literatura Latinoamericana / Errors in the preparation and administration of medications: an integrative review of Latin American literature

Objetivo: Analizar, respecto su contenido, la producción científica de enfermeros latinoamericanos sobre error en la preparación y administración de medicamentos entre el año 2005 al 2011, en las bases de datos Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (LILACS) y Biblioteca Electrónica Científica (SciELO). Metodología: Consistió en una revisión integradora. La recolección fue realizada en el mes de Octubre de 2012 y de acuerdo a los criterios de inclusión, fueron seleccionados ocho artículos. Resultados: Los artículos fueron analizados en cuanto a los objetivos, trayectoria metodológica, principales resultados y propuestas de mejora. El análisis señala producción exclusiva de Brasil, estudios descriptivos, realizados en hospitales y con sugerencias generales como educación continua, notificación de los errores, implementación de una cultura de seguridad. Conclusiones: Considerando los aspectos enfatizados por la Organización Mundial de Salud (OMS) para alcanzar una atención más segura: buscar causas, proponer soluciones y evaluar impacto, se concluye que la producción necesita conocimiento que efectivamente mejore la práctica. Impulsar la investigación analítica con la mirada al sistema permitirá el desarrollo de propuestas efectivas y de acorde a la realidad (AU)

Objective: To analyze the contents the scientific production of Latin American nurses regarding on preparation and administration of medical drugs from 2005 to 2011 using Latin American and Caribbean Center Information the Health Sciences (LILACS) y Electronics Scientific Library (SciELO) databases. Methodology: The following research was an integrative review. Data collection was performed in the month of October 2012 and according to the inclusion criteria, were selected eight articles. Results: The articles were analyzed in terms of objectives, methodological path, main results and suggestions for improvement. The analysis indicates exclusive production of Brazil, descriptive studies, conducted in hospitals and general suggestions as continuing education, error reporting and implementation of a safety culture. Conclusions: Considering that aspects emphasized by the World Health Organization (OMS) to achieve safer care are: to find causes, to propose solutions and to evaluate the impact, it is concluded that production need of knowledge that effectively improve professional practice. Looking to the system, promoting researches with analytical studies will allow effective responses according to reality (AU)

Importancia de un ambiente libre de interrupciones durante el proceso de preparación y administración de medicamentos para la seguridad del paciente / Importance of an interruption-free environment for the safety of the patient while preparing and administering medications

No disponible

No disponible