Errores en el proceso de medicación de pacientes internados en el Hospital Público Materno Infantil de Salta / Errors in the Medication Process of Inpatients at Hospital Público Materno Infantil de Salta

INTRODUCCIÓN: Los errores de medicación son causa de eventos adversos durante el proceso asistencial. OBJETIVOS: Caracterizar los errores en el proceso de medicación del Hospital Público Materno Infantil de Salta. MÉTODOS: Los errores fueron identificados a partir de la validación farmacéutica de las prescripciones. Se calcularon las tasas de error, y se analizó su asociación con factores del paciente, del tratamiento farmacológico y del recurso humano. RESULTADOS: Entre el 1 de noviembre de 2012 y el 31 de enero de 2013 se validaron 18 203 prescripciones, en las que se detectaron 2989 (96,7%) errores de prescripción, 79 (2,5%) de administración, 6 (0,2%) de transcripción y 18 (0,6%) de dispensa. La tasa de error del Área Perinatológica fue de 13,06 cada 100 días-paciente; se destacaron la omisión de dosis (30%) y la prescripción de dosis incorrecta (23%). En el Área Pediátrica la tasa fue de 8,6 cada 100 días-paciente, con 55% de prescripción de dosis incorrecta, asociada a la edad del niño. Los grupos farmacoterapéuticos involucrados fueron: analgésicos antiinflamatorios no esteroideos, drogas del aparato digestivo y circulatorio, y antiinfecciosos. La mayor parte de los errores se produjo con drogas de uso habitual, con consecuencias potencialmente significativas para los pacientes. La tasa de error fue similar para médicos en formación y de planta. CONCLUSIONES: La farmacovigilancia intensiva permitió identificar un número elevado de errores, cuya caracterización es útil para implementar estrategias de prevención.

INTRODUCTION: Medication errors cause adverse events in health care. OBJECTIVES: To characterize the medication process errors at Hospital Materno Infantil of Salta. METHODS: Errors were identified by pharmaceutical validation of prescriptions. Error rates were calculated, and associations between error and patient factors, drug treatment and human resource were determined. RESULTS: From November 1, 2012 to January 31, 2013 a total of 18 203 prescriptions were validated, identifying 2 989 (96.7%) errors of prescription, 79 (2.5%) of administration, 6 (0.2%) of transcription and 18 (0.6%) of dispensing. The error rate was 13.06 per 100 patient days for the Perinatology Area, with 30% of omission of doses and 23% of incorrect dose prescription. In the Pediatric Area, the rate was 8.6 per 100 patient days, with 55% of wrong doses, associated with child age. The pharmacotherapeutic groups involved were: non-steroidal anti-inflammatory drugs, digestive and circulatory system drugs, and anti-infectives. Most errors occurred with commonly used drugs, with potentially significant consequences for patients. The error rate was similar to doctors in training and permanent staff. CONCLUSIONS: Intensive pharmacovigilance allowed the identification of a large number of errors. Their characterization will permit to establish prevention strategies.

Adhesion of Lactobacillus vaginal strains with probiotic properties to vaginal epithelial cells

The capability of lactobacilli to adhere to vaginal epithelial cells (VEC) has been found to be an important factor in the formation of a barrier to prevent colonization of pathogenic bacteria. The aim of this study was to examine the adhesion ability to VEC, of vaginal Lactobacillus which had been selected for their probiotic properties. A modification of the Mardh and Westr÷n method was employed for this purpose. Adherent bacteria were determined as CFU-grown using selective media. There was a slight degree of difference in the adhesion properties observed among vaginal and non-vaginal Lactobacillus. Different pH values of 4 and 7 did not affect adhesion (P < 0.70). Scanning and transmission electronic microscopy were performed to illustrate the adhesion of the self-aggregating L. salivarius CRL 1328.