Segurança na prescrição de medicamentos de um hospital de ensino

Abstract

The overall objective of this study was to identify the accession from the recommendations of the Protocol of the Ministry of health and ANVISA in structure of prescription medicines in a teaching hospital. This is a methodological study, retrospective, and quantitative approach has been developed in two steps. The step I was characterized by the development of the instrument, called a Safety Checklist on prescription Medicines (LVSPM); apparent validation and content of the instrument and instrument reliability. To test the reliability and responsiveness were used the coefficient Kappa and the Intraclass correlation coefficient between scores obtained in relation to the observations of the researchers. Step II has been characterised by the application of the instrument. The target population for this study was made up of electronic prescriptions 2346 inpatients in the period from January to December 2014 in medical and surgical Clinics of the teaching hospital. It conducted a random drawing was held to obtain the sample (n = 313). However, considering the losses, 214 electronic prescriptions were analysed. After approval by the Committee of ethics in research, data were collected from printed and electronic prescriptions were analyzed using the statistical program Statistical Package for Social Sciences (SPSS) version 20.0. It was noted that the reliability of the instrument was perfect (Kappa = 1.00) and excellent (ICC = 1.00) and statistically significant (p < 0.001). 214 printed electronic prescriptions were analyzed, totalizing 1849 prescription drugs. There has been an average of 8.64 medicines by prescription, with a variation of 2 to 8 medicines, median and standard deviation of 3.45 8.00. It was observed that all the prescriptions were dated, all medicines were prescribed in Brazilian common name used point to replace the comma in the prescription dose and medication used zero before the comma. Identified accession of 99.95% related to short route of administration as standardization; 89.33% for prescriptions that were the use of expressions related to duration of treatment; 63.43% did not use expressions of non-metric measures; 63.02% unit of measure was clearly indicated and; 56.03% had information on diluents. Medicines prescribed for short (32.08%); lack of definition of speed infusion (36.34%) did not contain requirements number/letter of the bed (2.8%) and signature of the prescriber (2.8%). Concerning the use of the term "if necessary" with all necessary information, that's what showed lower membership fee (1.57%). There was no membership in the use of the pharmaceutical form with all the necessary information for prescription drugs. The average score of general membership was 73.49%, being the least of 55.95% and maximum of 87.89%. The relationship between number of medicines and the General score, a Pearson Coefficient, r =-0.29, p < 0.001, i.e. the number of medicines in a prescription increases, the overall score of accession diminishes. It is hoped that this study will help to warn and educate the users about the importance of a correct and safe prescription, thus enabling higher quality care and safe use of medicines.