Potential drug-drug interactions and polypharmacy in institutionalized elderly patients in a public hospital in Brazil.

WHAT IS KNOWN ON THE SUBJECT?: Older individuals constitute an increasing proportion of the population, and therefore, are the major consumers of drugs. The elderly, especially those with mental disabilities, frequently develop chronic diseases and start using numerous drugs. Drug-drug interactions (DDIs) are a major clinical problem in the elderly population, and previous studies have focused only on antidepressants and others types of drugs used to treat mental health conditions. WHAT THIS ARTICLE ADDS TO EXISTING KNOWLEDGE?: This study shows that in hospitalized elderly patients with mental disorders (aged 60-69 years), polypharmacy (≥5 drugs) and the use of drugs that act on the cardiovascular, respiratory and nervous systems can lead to potential drug-drug interactions. Moreover, it was reported that the prevalence of drug-drug interactions in elderly patients with mental disorders was high during their hospitalization in a public hospital in Brazil. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Nurses should know the factors associated with drug-drug interactions in hospitalized elderly patients with mental disorders to choose appropriate strategies for avoiding treatment failure and adverse events in patients. ABSTRACT: Introduction Despite the impact on patient safety and the fact that prevalence is higher in older patients, previous research did not analyse drug-drug interactions (DDIs) in view of nursing care of elderly psychiatric patients. Aim To identify potential drug-drug interactions and polypharmacy in prescriptions of aged inpatients with psychiatric disorders and analyse associated factors. Methods In this retrospective cross-sectional study, we analysed the medical records of institutionalized patients diagnosed with psychiatric disorders (n = 94), aged >60 years, and prescribed multiple medications. Drug prescriptions were checked at admission, midway through and the last prescription. Factors associated with DDI occurrence were assessed using multivariable logistic regression analysis. Results A DDI prevalence potential of 67.0%, 74.5% and 80.8% occurred in patients at admission, midway through hospitalization and the last prescription, respectively. Most of the prescribed drugs were nervous system agents. A high percentage of serious and contraindicated potential DDIs occurred. Age between 60 and 69 years, use of cardiovascular and respiratory system drugs, and the number of medications contributed significantly to DDI. Implications for mental health nursing Knowledge on the factors associated with DDIs in patients with mental disorders can contribute to the improvement of effectiveness and safety of nursing care.

Attitudes towards suicidal behaviour and associated factors among nursing professionals: A quantitative study.

WHAT IS KNOWN ON THE SUBJECT?: Self-confident health professionals with positive and understanding attitudes can take better care of people with suicidal behaviour, but the factors associated with these attitudes are not known. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The majority of nursing professionals had no experience or training in mental health or suicide. They were less self-confident and had more negative attitudes. Nurses and nursing assistants who worked before in mental health services were more understanding with people with suicidal behaviour. Nurses and nursing assistants who were working in prehospital services were less self-confident to taking care of people with suicidal behaviour. Some members of the nursing team had already seriously considered committing suicide. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The practicing, support and training in mental health may improve the nurses' attitudes and emotional competencies. It is important to know why few nurses had suicide-related training, despite the relevance of this issue. Training in mental health or suicide need to include attitudinal and emotional competencies. It is important to offer emotional support to emergency nursing professionals. ABSTRACT: Background The attitudes towards suicide of emergency nurses may affect the care provided. However, the factors associated with these attitudes remain unclear. Objective To investigate attitudes towards suicidal behaviour and associated factors among nursing professionals working in emergency settings. Methods A cross-sectional observational study including 28 nurses and 118 who were nursing assistants employed at two emergency services in Brazil was conducted. Data were collected in 2015 using a self-administered sociodemographic questionnaire and the Suicide Behavior Attitude Questionnaire (SBAQ). Results The majority of participants reported having no experience or training in mental health or suicide. They reported more negative feelings towards the patient and a lower self-perception of professional competence regarding suicidal behaviours, and these attitudes seemed to reinforce each other. Nurses who worked in mental health services reported less moralistic/judgemental attitudes. Working in prehospital services was associated with having a lower self-perception of professional competence. There were professionals who reported thinking seriously about committing suicide. Conclusion When combined with support and training, practicing mental health nursing may serve as an opportunity to develop favourable attitudes and emotional competences, and these issues need to be addressed in suicide education strategies.

[Drug administration and information dissemination via online]. / Administração de medicamentos ea comunicação de conhecimento via online.

The present study aims at verifying and describing how on-line communication of nursing knowledge concerning administration of medication is taking place. In order to assess the websites, the search tool Meta Busca-Terra (www.terra.com.br) was used. One hundred and sixty-six websites were found; however, only 45 were related to the topic. These were analyzed and categorized according to types of presentation, websites, languages, and homepages. It was verified that they presented common characteristics, such as: Articles (18), Informative Bulletins (8) and Medication Advertisements (7). Regarding the websites, Yahoo distinguished from the others, since it featured 34 websites. The predominant language was English, which was found in 36 websites. The on-line communication of knowledge is fundamental in regard to administration of medication for it allows the dissemination of knowledge at a faster and more productive pace. Undoubtedly, clients and professionals will be highly benefited.

[Errors in drug administration: knowledge diffusion and identification of the patients as important aspects]. / Erros na administração de medicamentos: divulgação de conhecimentos e identificação do paciente como aspectos relevantes.

The administration of medications is a multi-system process. Errors can happen in all the stages of that process. Strategies can be used and it should be published to minimize the occurrence of errors. This study had the following objectives: to identify and to analyze publications with themes about the administration of medication in nursing, hospital and pharmacy journals and to verify the identification in the bed and in the patients' forearm in impatient clinics. To reach the first objective it was realized a revision of the literature in three journals of larger national circulation of the described areas, in the period from 1987 to 1997. The identified articles were classified in 5 types: nursing staff, teaching, medications, research and technique. It was identified 19 articles on the thematic studied, being 42.1% of these related to the technical aspects of the administration of medications. To reach the second objective it was taken an investigation of one day, chosen accidentally, being verified the identification of the beds and the patients in the 360 beds of the institution. Of these, 74.7% were busy and 75.8% properly identified. It was observed that 23.8% of the patients have gotten bracelet of placed identification, in the day previous to the surgery and not in the moment of the hospitalization. The results evidenced the need to increase the publication of the studies about errors and to increase actions that minimize the occurrence of errors in the medication in impatient patients.

[The most common errors and risk factors in the administration of medicines at basic health units]. / Erros mais comuns e fatores de risco na administração de medicamentos em unidades básicas de saúde.

The present study identified and analyzed the opinions of nurses and nursing professionals about the more common risk factors regarding errors in medicine administration as well as the consequences, interventions and measures to minimize this problem. Therefore, the authors applied an instrument of data collection with questions on the opinions of the nursing professionals who work at the Basic Health Units from a city of the state of São Paulo. Results showed that the risk factors associated to the professional were lack of attention and difficulty to understand medical prescriptions. The interventions were related to punishment and education and the proposals to minimize the occurrences were orientation and up-date of the involved professionals.