Identificação e caracterização dos erros de prescrição e intervenções farmacêuticas realizadas na Unidade de Emergência Referenciada (UER) do Hospital de Clínicas/Unicamp

Abstract

Emergency Departments are conducive environments for the occurrence of adverse events such as medication errors due to factors such as overcrowding of services and length of stay for patients that generate work overload for the health care team and worsen in the quality of care indicators. Thus, the presence of the clinical pharmacist would be essential for the identification and prevention of prescription errors, contributing positively to patient safety. Therefore, the objective of the study was to identify, quantify and characterize the prescription errors and pharmaceutical interventions performed in an emergency unit to demonstrate the clinical impact of clinical pharmacist work for patient safety. In this study, medication errors and pharmaceutical interventions were identified, quantified, characterized according to the clinical impact and correlated with indicators of occupancy rate and length of stay. This is a prospective and quantitative study that was conducted for a period of 20 months in the Emergency Department of the Hospital de Clínicas, State University of Campinas, Brazil. A total of 32173 prescriptions were analyzed, 4.1% of which contained some type of error and generated 1499 pharmaceutical interventions, with 95.4% acceptability. Most prescription errors were classified as serious (53.5%) and were mostly related to the supratherapeutic dose of medication (26.8%). Most of the accepted pharmaceutical interventions were classified as very clinically significant (54.4%). The medication most related to prescription errors was enoxaparin (14.7%) and the class was that of the medications of the alimentary tract and metabolism (33.4%). It was possible to observe a correlation between the rate of prescriptions with an error and the length of stay (ρ: 0.6961 / P-value: 0.007) and also between the severity of the error and the length of stay. The clinical pharmacist was able to effectively identify prescription errors in the prescriptions of patients seen in the emergency room, avoiding adverse drug-related events.