Lucas Miyake Okumura , Daniella Matsubara da Silva , Larissa Comarella
{"title":"儿科重症监护病房药物安全使用与临床药学服务的关系","authors":"Lucas Miyake Okumura , Daniella Matsubara da Silva , Larissa Comarella","doi":"10.1016/j.rpped.2016.03.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).</p></div><div><h3>Methods</h3><p>This is a cross‐sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.</p></div><div><h3>Results</h3><p>Of 53 patients accompanied, we detected 141 preventable drug‐related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non‐optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.</p></div><div><h3>Conclusions</h3><p>Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence‐based strategies to reduce morbidity related to medications.</p></div>","PeriodicalId":21311,"journal":{"name":"Revista Paulista De Pediatria","volume":"34 4","pages":"Pages 397-402"},"PeriodicalIF":1.4000,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rpped.2016.03.004","citationCount":"0","resultStr":"{\"title\":\"Relação entre o uso seguro de medicamentos e Serviços de Farmácia Clínica em Unidades de Cuidados Intensivos Pediátricos\",\"authors\":\"Lucas Miyake Okumura , Daniella Matsubara da Silva , Larissa Comarella\",\"doi\":\"10.1016/j.rpped.2016.03.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).</p></div><div><h3>Methods</h3><p>This is a cross‐sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.</p></div><div><h3>Results</h3><p>Of 53 patients accompanied, we detected 141 preventable drug‐related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non‐optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.</p></div><div><h3>Conclusions</h3><p>Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence‐based strategies to reduce morbidity related to medications.</p></div>\",\"PeriodicalId\":21311,\"journal\":{\"name\":\"Revista Paulista De Pediatria\",\"volume\":\"34 4\",\"pages\":\"Pages 397-402\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2016-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.rpped.2016.03.004\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista Paulista De Pediatria\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0103058216300028\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Paulista De Pediatria","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0103058216300028","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
Relação entre o uso seguro de medicamentos e Serviços de Farmácia Clínica em Unidades de Cuidados Intensivos Pediátricos
Objective
Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).
Methods
This is a cross‐sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.
Results
Of 53 patients accompanied, we detected 141 preventable drug‐related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non‐optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.
Conclusions
Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence‐based strategies to reduce morbidity related to medications.
期刊介绍:
The Revista Paulista de Pediatria publishes original contributions, case reports and review of clinical research with methodological approach in the areas of health and disease of neonates, infants, children and adolescents. The objective is to disseminate research with methodological quality on issues that comprise the health of children and adolescents. All articles are freely available online, via SciELO. Its abbreviated title is Rev. Paul. Pediatr., which should be used in bibliographies, footnotes and bibliographical references and strips.