Evaluation of adverse drug events in the hospital context
Evaluación de los eventos adversos a medicinas en el contexto hospitalar
Avaliação dos eventos adversos a medicamentos no contexto hospitalar
Keroulay Estebanez Roque; Enirtes Caetano Prates Melo
Abstract
This study aimed to evaluate the occurrence of adverse events in a public cardiology hospital, located in the municipality of Rio de Janeiro and classify adverse events in relation to the severity of the damage. This is an investigation based on retrospective review of medical records. We analyzed a random sample of 112 medical records of patients hospitalized from December 2007 to February 2008. Nurse reviewers selected records with potential adverse drug events and a group of evaluators confirmed the occurrence of adverse events and classified according to the damage. The incidence of adverse drug events was 14.3%. In 31.2% of cases in which the event was detected, intervention was needed to support life. The detection of adverse events in hospitals enables to know failures medication as well as implement strategies to reduce them.
Keywords
Resumen
Este estudio tuvo como objetivo evaluar la ocurrencia de eventos adversos en un hospital público de medicina y cardiología, ubicado en el municipio de Rio de Janeiro, y clasificar los eventos adversos en relación con la gravedad de los daños. Se trata de una investigación basada en una revisión retrospectiva de las historias clínicas. Se analizó una muestra aleatoria de 112 historias clínicas de pacientes hospitalizados entre diciembre de 2007 y febrero 2008. Las enfermeras revisoras eligieron los registros con potencial de eventos adversos por medicamentos y un grupo de evaluadores confirmaron la ocurrencia de eventos adversos y se clasifican de acuerdo al daño. La incidencia de eventos adversos por medicamentos fue de 14,3%. El 31,2% de los casos en que se detectó la intervención, era necesario hacerla para mantener la vida. La detección de eventos adversos en los hospitales permite descubrir errores en la administración de los medicamentos, así como aplicar estrategias para reducirlos.
Palabras clave
Resumo
Palavras-chave
Referências
1. Rozenfeld S, Chaves SMC, Reis LGC, Martins M, Travassos C, Mendes W, et al . Efeitos adversos a medicamentos em hospital público:estudo piloto. Rev Saude Publica 2009 out;43(5):887-90.
2. Cano FG, Rozenfeld S. Adverse drug events in hospitals:a systematic review. Cad Saude Publica. 2009;25(supl 3):S360-S372.
3. Mendes W, Martins M, Rozenfeld S, Travassos C. The assessment of adverse events in hospitals in Brazil. Int J Qual Health Care. 2009;21:279-84.
4. Senst BL, Achusim LE, Genest RP Cosentino LA, Ford, CC, Little JA, et al. Practical approach to determining costs and frequency of adverse drug events in a health care network. Am J Health Syst Pharm 2001;58:1126- 132.
5. Mycyk MB, McDaniel MR, Fotis MA, Regalado J. Hospital wide adverse drug events before and after limiting weekly work hours of medical residents to 80. Am J Health Syst Pharm. 2005;62:1592- 595.
6. Davies EC, Green CF, Taylor S, Williamson PR, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients:a prospective analysis of 3695 patient-episodes. PLoS One 2009;4:e4439.
7. Davies EC, Green CF, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients:a pilot study. J Clin Pharm Ther 2006;31:335-341.
8. Dormann H, Neubert A, Criegee-Rieck M, Egger T, Radespiel-Tröger M, Azaz-Livshits T, et al. Readmissions and adverse drug reactions in internal medicine:the economic impact. J Intern Med. 2004;255:653-63.
9. Melo ABR, Silva LD. Segurança na terapia medicamentosa:uma revisão bibliográfica. Esc Anna Nery. 2008;12(1):166-72.
10. Zhang M, Holman CDA, Price SD, Sanfilippo FM, Preen DB, Bulsara M. Comorbidity and repeat admission to hospital for adverse drug reactions in older adults:retrospective cohort study. British Medical Journal 2009;338a:2752.
11. Gimenes FRE, Teixeira TCA, Silva AEBC, Optiz SP, Mota MLS, Cassiani SHDB. Influência da redação da prescrição médica na administração de medicamentos em horários diferentes do prescrito. Acta Paul. Enferm. 2009;22(4):380-84.
12. Federico F. Preventing harm from high-alert medications. Jt Comm J Qual Patient Saf. 2007;33(9):537-42.
13. Rozich JD, Haraden CR, Resar RK. Adverse drug event trigger tool:a pratical methodology for measuring medication related harm. Qual Saf Health Care 2003;12(3):194-200.
14. Roque KE, Melo ECP. Adaptação dos critérios de avaliação de eventos adversos a medicamentos para uso em um hospital público no Estado do Rio de Janeiro. Rev Bras Epidemiol. 2010;13(4):607-19.
15. National Coordinating Council for Medication Error Reporting and Prevention [homepage na Internet]. Rockville: Taxonomy of medication errors. 2009 [cited 2009 Ago 10]. Available from:
16. Classen DC, Resar R, Griffin F, Federico F, Frankel T, Kimmel N, Whittington JC, Frankel A, Seger A, James BC. Global trigger tool' shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff , Millwood, 2011;30(4):581-89.
17. Majerus PW, Tollefsen DM. Coagulação sanguínea e anticoagulants, trombolíticos e fármacos antiplaquetários. In:Bruton LL, Lazo JS, Parker KL. Goodman & Gilman:as bases farmacológicas da terapêutica. Rio de Janeiro: McGraw-Hill; 2006.p.1321-339.
18. Rang HP, Dale MM, Ritter JM, Flower RJ. O coração. In:Rang HP, Dale MM, Ritter JM, Flower RJ. Rang & Dale: farmacologia. Rio de Janeiro: Elsevier; 2007. p. 277-97.
Submetido em:
12/04/2011
Revisado em:
30/09/2011
Aceito em:
10/10/2011