BackgroundThe role of the hospital pharmacist has evolved in the last years and is becoming a more frequent presence in the medical teams, and is acquiring a fundamental role in pharmacotherapeutic decision-taking.PurposeTo analyse the pharmaceutical interventions (IF) performed during 3 years in a general and digestive surgery unit (CGD) by a clinical pharmacist after integration into the team.Material and methodsThe pharmaceutical interventions performed in the general and digestive surgery unit were selected from the database (April 2014 to March 2017). The main activity was carried out with the coloprocto rectal surgery team participating in the daily checking visiting room with them, and the subsequent follow-up. For the evaluation of pharmaceutical interventions, an Excel tool has been developed, classifying them according to the Isofar®program.Results2,263 IF were performed, classified in nine items. In frequency order these were: initiation of treatment (782), nutritional adjustments (496), drug suspension (348), dose modification (193), drug change (129), modification of pharmaceutical form/administration route (116), confirmation of prescriptions (95), frequency modifications (77) and pharmacokinetic monitoring (27). Of the three most frequent items, regarding the start of treatment, 49% of the 782 IF were due to the need for additional treatment and 51% to non-prescribed home treatment. From the 496 IF of nutritional adjustments: 55.6% are due next to nutrition, 29.6% to adjustment of nutritional requirements, 7.4 to volume modifications, 3.7% to suspend nutrition and 3.7% to modify type of nutrition. Referring to the suspension of medication, from the 348 IF performed, the 40% correspond to therapeutic duplicity, 40% to excessive duration, 15% to non-indicated medicament and 5% to the prevention of adverse reactions.ConclusionThe key points of the role of the clinical pharmacist in surgery are based on the IFs performed and the reconciliation of home medication and nutrition.The integration of the clinical pharmacist into the surgical care team is fundamental in the optimisation of pharmacotherapeutic treatment.References and/or AcknowledgementsAcknowledgements to all the general surgery teamNo conflict of interest

BackgroundPaediatric patients are one of the population groups with the highest risk of medication error. Their characterisation will allow us to develop strategies to prevent these and improve the safety of patients.PurposeTo characterise the incidents associated with the use of antibiotics in paediatric patients who present in the Emergency Department (ED): identify the drugs, categorise types and causes of errors, determine the severity and analyse the factors that influence its occurrence.Material and methodsA prospective observational study of the incidents detected in the ED during a period of 3 months in 2017. For data collection, a form was used that included: demographic data of the patient, medication involved, type of error or adverse event, severity, causes and latent factors, process of the therapeutic chain where the error occurred and trigger tools for detection.ResultsThere were 15 504 visits to the ED during the study period, among which were detected 65 incidents related to medication (incidence=0.4%). Forty-nine per cent were related to the use of antibiotics. The drugs reported were amoxicillin (n=13), amoxicillin-clavulanic (n=10), azithromycin (n=5), cefuroxime-axethyl (n=1), phenoxybenzylpenicillin (n=1) and metronidazole (n=1). Incidents were classified as non-preventable adverse events (9.4%), detected by warning signs (diarrhoea, skin rash and hypersensitivity reaction) and medication errors (90.6%). Of the total errors, 97% were in the prescribing process: 13 cases for underdosing, three cases for overdose and in 12 cases the medication was not indicated for diagnosis. A single case was in the dosing default administration process. In 48% of cases, the error reached the patient but did not cause damage and in 52% the error caused temporary damage to the patient and required treatment or intervention. The latent factors described in 87% of the cases were lack of knowledge and training about the medication, and lack of follow-up of clinical guidelines.ConclusionA high number of incidents related to antibiotic treatment have been observed in paediatric patients, mostly on prescription. We recommend the development of joint therapeutic guides between Primary Health Care and specialised care aimed at the safe use of antibiotics, focusing on the adequacy of the antibiotic and the dose based on the infectious process.No conflict of interest