Aplicación de los nuevos criterios de prescripción inadecuada STOPP-START a pacientes geriátricos institucionalizados / Application of the new STOPP-START criteria of inappropriate medication prescription in geriatrics in an institutional care setting

Objetivo. Identificar medicación inadecuada y fármacos necesarios no prescritos en pacientes de cuatro residencias geriátricas y cuantificar la modificación de tratamientos que realizan médicos a partir de las recomendaciones hechas por farmacéuticos. Material y métodos. Estudio cuasi experimental pre-post sin grupo control. La intervención consistió en la comunicación de prescripciones inapropiadas, basadas en los criterios STOPP-START, detectadas en los médicos responsables. Resultados. Se revisaron las historias clínicas de 121 pacientes mayores de 65 años. Ochenta y ocho pacientes (72,7%) presentaron como mínimo un criterio STOPP-START, con una media de 2 criterios por paciente. Se observó al menos una potencial prescripción inadecuada (STOPP) en 79 pacientes (65,3%) y una omisión de un tratamiento necesario (START) en 36 pacientes (29,7%). El médico aceptó como mínimo uno de los criterios detectados y modificó el tratamiento de 47 pacientes (53,4%). Se cambió el tratamiento de 33 pacientes (41,8%) siguiendo los criterios STOPP y de 20 pacientes (55,5%) según los criterios START. Conclusión. La prescripción inadecuada de fármacos y la no utilización de fármacos necesarios es un problema frecuente en geriatría (AU)

Objective. This study has aimed to determine the prevalence of inappropriate prescribing (IP) and of necessary drugs not prescribed in a geriatric population living in four assisted care nursing homes and to quantify the changes in medications made by physicians based on the recommendations made by the pharmacists. Methods. A pre-post quasi-experimental study without a control group was performed. The intervention consisted of the communication of inappropriate prescriptions based on the STOPPSTART criteria to the responsible physicians Results. The medical records of 121 patients over 65 year were reviewed. Of these, 88 patients (72.7%) had at least one STOPP-START criterion, with an average of 2 criteria per patient. At least one potential inappropriate drug (STOPP criterion) was detected in 79 patients (65.3%) and 36 patients (29.7%) were not receiving at least one drug indicated for their diseases (START criterion). The practitioners accepted at least one of the criteria detected and modified the medical prescription of 47 patients (53.4%). Treatment was modified in 33 patients (41.8%) following the STOPP criteria and 20 patients (55.5%) following the START criteria. Conclusion. Inappropriate drug prescription and the lack of using of the necessary medications is a frequent problem in older patients (AU)

Descripción del proceso de certificación ISO 9001/2000 en el área de nutrición parenteral / No disponible

Objetivo: Garantizar la calidad y seguridad e incrementar la satisfacción del usuario ha llevado a organizaciones del ámbitosanitario a integrar un sistema de gestión de calidad en su estructura. Este trabajo describe el proceso de implantación dela norma UNE-EN-ISO-9001/2000 en el área de nutriciónparenteral.Método: Un grupo multidisciplinar definió el alcance de la norma, centrándose en transcripción, acondicionamiento, dispensacióny control microbiológico.Resultados: Se elaboró un procedimiento detallando secuencialmente los circuitos y actividades asociadas, el personal responsable y las pautas de actuación a seguir. Se establecieron indicadoresde calidad y de actividad.Conclusiones: Este proceso ha permitido establecer un sistema normalizado cuyos procesos están perfectamente descritos y documentados, logrando la trazabilidad y supervisión de las fases.Al no disponer de histórico de los datos actualmente obtenidos, no es posible establecer una comparación directa; por tanto, deberá analizarse su evolución en un futuro

Objective: In order to guarantee quality and safety and to increase user satisfaction, healthcare organisations have integratedquality management systems into their structures. This study describes the process for introducing the UNE-EN-ISO-9001/2000 standard in the parenteral nutrition area.Method: A multidisciplinary group established the scope of the standard, focusing on transcription, preparation, dispensation and microbiological control.Results: A detailed procedure describing the sequences of circuits and associated activities, the responsible staff and the action guidelines to be followed was established. Quality and activity markers were also established.Conclusions: This process has enabled a standard system to be implemented, with its operation perfectly described and documented, allowing its stages to be traceable and supervised. As there is no record of the data obtained beforehand, no direct comparison can be made; its evolution must therefore be analysed inthe future

[Description of the ISO 9001/2000 certification process in the parenteral nutrition area]. / Descripción del proceso de certificación ISO 9001/2000 en el área de nutrición parenteral.

OBJECTIVE: In order to guarantee quality and safety and to increase user satisfaction, healthcare organisations have integrated quality management systems into their structures. This study describes the process for introducing the UNE-EN-ISO-9001/2000 standard in the parenteral nutrition area. METHOD: A multidisciplinary group established the scope of the standard, focusing on transcription, preparation, dispensation and microbiological control. RESULTS: A detailed procedure describing the sequences of circuits and associated activities, the responsible staff and the action guidelines to be followed was established. Quality and activity markers were also established. CONCLUSIONS: This process has enabled a standard system to be implemented, with its operation perfectly described and documented, allowing its stages to be traceable and supervised. As there is no record of the data obtained beforehand, no direct comparison can be made; its evolution must therefore be analysed in the future.