Errores de medicación en la Unidad de Cuidados Intensivos / Medication errors in the Unit Intensive Care

The safety and quality care are two attributes of the health care that are closely related. The critically ill patients are vulnerable to medical errors, and may experience preventable adverse events, often associated with drugs. The errors in the medication use process may occur at any stage, it is ordering, transcription, dispensing, preparation or administration. Medication errors (ME) can occur in one third of patients hospitalized in an ICU and have the potential to cause permanent damage to patients and longer hospital stay, with the resulting emotional and financial cost associated. Although technology can reduce the likelihood for adverse drug events, the optimal methods for implementation, integration, and evaluation in clinical practice remain unclear. In this paper we present some strategies and interventions to reduce the incidence of ME and optimize the safety and quality of care of critically ill patients (AU)

Errores de medicación en pacientes críticos adultos de un hospital universitario: Estudio prospectivo y aleatorio / Prospective assessment of medication errors in critically ill patients in a university hospital

Background: Critically ill patients are especially vulnerable to medication errors (ME) due to their severe clinical situation and the complexities of their management. Aim: To determine the frequency and characteristics of ME and identify shortcomings in the processes of medication management in an Intensive Care Unit. Patients and Methods: During a 3 months period, an observational prospective and randomized study was carried out in the ICU of a university hospital. Every step of patient's medication management (prescription, transcription, dispensation, preparation and administration) was evaluated by an external trained professional. Steps with higher frequency of ME and their therapeutic groups involved were identified. Medications errors were classified according to the National Coordinating Council for Medication Error Reporting and Prevention. Results: In 52 of 124 patients evaluated, 66 ME were found in 194 drugs prescribed. In 34% of prescribed drugs, there was at least 1 ME during its use. Half of ME occurred during medication administration, mainly due to problems in infusion rates and schedule times. Antibacterial drugs had the highest rate of ME. Conclusions: We found a 34% rate of ME per drug prescribed, which is in concordance with international reports. The identification of those steps more prone to ME in the ICU, will allow the implementation of an intervention program to improve the quality and security of medication management.