RESUMO
PURPOSE: To conduct a Health Care Failure Mode and Effects Analysis (HFMEA) of the chemotherapy preparation process to identify the steps with the potential to cause errors, and to develop further strategies to improve the process and thus minimize the risk of errors. METHODS: An HFMEA was conducted to identify and reduce preparation errors during the chemotherapy preparation process. A multidisciplinary team mapped the preparation process, formally identified all the steps, and then conducted a brainstorming session to determine potential failure modes and their potential effects. A severity and probability score for each failure mode, a hazard score (HS) and a total HS were calculated. A hazard analysis was conducted for each HS equal to or more than 8. Finally, an action plan was identified for each failure mode. After the action plan was implemented, failure modes were revaluated and a new HS score was calculated as well as the percentage decrease in risk. RESULTS: The team identified five main steps in the chemotherapy preparation process and nine potential failure modes. After implementing the control measures, all the HSs decreased. The total HS associated with the chemotherapy preparation process decreased from 54 to 26 (-52%). This reduction in the total HS was mainly achieved by updating the Standard Operating Procedures (SOPs) and implementing bar code and gravimetric control system. CONCLUSION: The application of HFMEA to the chemotherapy preparation process in centralized chemotherapy units can be very useful in identifying actions aimed at reducing errors in the healthcare setting.
Assuntos
Análise do Modo e do Efeito de Falhas na Assistência à Saúde , Atenção à Saúde , HumanosRESUMO
El consumo de productos de plantas medicinales, para la prevención y/o tratamiento de diversos problemas de salud, ha experimentado un notable incremento en el estado español, especialmente en las farmacias. Esto es debido entre otros factores a la constatación científica de su eficacia y seguridad y a la labor profesional realizada por parte de los farmacéuticos en la recomendación de estos preparados. En este trabajo se realiza una evaluación de las necesidades de formación de los farmacéuticos en la ciudad de Madrid como base fundamental para realizar una buena dispensación de plantas medicinales, en res- puesta a la demanda de los pacientes. Respecto a estudios anteriores, los resultados obtenidos indican un incremento en la demanda de preparados de plantas medicinales por parte de los pacientes, principalmente mujeres. Asimismo se aprecia una mayor tendencia a elegir la oficina de farmacia como lugar de adquisición, al reconocer la mejor cualificación del farmacéutico en esta materia. No se observa una modificación sustancial en cuanto a la demanda por grupos terapéuticos, si bien la crisis económica parece influir en un incremento de la dispensación de plantas para el tratamiento de la ansiedad. Los farmacéuticos encuestados muestran su interés por ampliar y actualizar los conocimientos en fitoterapia mediante acciones formativas directas y próximas (AU)
The consumption of herbal products for the prevention and / or treatment of various health problems, has seen a remarkable increase in the Spanish state, especially in pharmacies, this is due among other factors to the scientific findings of its effectiveness and safety and the great effort made by pharmacists in the recommendation of these preparations. This paper assesses the training needs of pharmacists in the city of Madrid as the foundation for a good dispensing of medicinal plants, in response to patient demand. The results we get indicate an increase in the demand of natural preparations on the part of patients, ainly women. Also there is a greater tendency to choose the pharmacy as a place to buy it, recognizing that the pharmacist is more qualified in this area. We do not find a substantial change in the demand for treatment groups, but the economic crisis seems to influence in the consume of phytotherapy plant ìs for the treatment of anxiety. The pharmacists of the study show their interest in increase and update their knowledge in herbal drug with compatible courses with their professional lifes (AU)
Assuntos
Humanos , Masculino , Feminino , Avaliação das Necessidades/organização & administração , Avaliação das Necessidades/normas , Avaliação das Necessidades , Formulários como Assunto/normas , Farmacêuticos/organização & administração , Farmacêuticos/normas , Assistência Farmacêutica/normas , Assistência Farmacêutica , Automedicação/métodos , Automedicação/normas , Fitoterapia/instrumentação , Fitoterapia/métodos , Fitoterapia , Preparações Farmacêuticas/normas , Boas Práticas de Dispensação , Medicamentos do Componente Especializado da Assistência Farmacêutica , Medicamentos de Venda Assistida/normasRESUMO
El mangostán (Garcinia mangostana L.) es un árbol tropical, de origen asiático, perteneciente a la familia de las Gutíferas, cuyos frutos de color rojo a púrpura y pulpa blanquecina se emplean en alimentación por su agradable sabor aromático, ligeramente ácido. Se utiliza además en distintas medicinas tradicionales del sudeste asiático para el tratamiento de la diarrea, infecciones de la piel y heridas crónicas, disentería amebiana y algunos procesos inflamatorios. Sus principales componentes son de tipo fenólico, en concreto del grupo de las xantonas isopreniladas, como α -, β - y γ -mangostinas, garcinona E y otras. Se han estudiado sus propiedades anticancerosas, analgésicas y antiinflamatorias, antidepresivas, antimicrobianas, antifúngicas y antivirales. A pesar de los múltiples estudios publicados, son pocos los realizados en humanos por lo que al día de hoy es necesario ser prudentes a la hora de aconsejar este fruto para el tratamiento de enfermedades (AU)
The mangosteen (Garcinia mangostana L.) is a tropical, Asian tree that belongs to the Gutifferae family. Its red to purple fruits with white pulp are edible and have a pleasant aromatic, slightly acid flavour. Moreover they are used in different traditional medicines from Southeast Asia against diarrhoea, skin infections and chronic wounds, amoebic dysentery and some inflammatory processes. Their main constituents are polyphenols, especially isoprenylated xanthones, such as α -, β - and γ -mangostin, garcinone E, and others. Its anticancer, analgesic and anti-inflammatory, neuropsychiatric, antimicrobial, antifungal and antiviral properties have been studied. Despite multiple published studies, very few have been done on humans. Thus, nowadays it is necessary to be cautious when advising this fruit to treat diseases (AU)
