Contenuto dell'articolo principale
Abstract
RIASSUNTO
La somministrazione farmacologica in un ambito come quello della sala operatoria è estremamente complesso sia per la tipologia di farmaci sia per il contesto. Tutto ciò aumenta a livello esponenziale la complessití del lavoro e la possibilití di incorrere in errori. Gli obbiettivi dello studio sono quelli di analizzare come nelle sale operatorie viene organizzata la conservazione dei farmaci, quali caratteristiche ha la prescrizione farmacologica e la modalití operativa dell'infermiere. E' stato condotto uno studio descrittivo prospettico in otto sale operatorie di una Azienda Ospedaliero Friulana. Sono state analizzate le prescrizioni farmacologiche avvenute in 96 giornate lavorative. Sono stati analizzati 257 processi di somministrazione farmacologica. Il 100% delle sale operatorie conserva i farmaci in ordine alfabetico e per nome commerciale. Nel 50% (104/208) delle preparazioni farmacologiche vengono utilizzate etichette con codice colore e nelle restanti si utilizzano etichette libere. Nel 69,2% (144/208) dei casi vi sono dei doppi controlli della prescrizione che si effettuano tra medico ed infermiere e nel 29,8% (62/208) dei casi vi sono doppi controlli della preparazione del farmaco tra medico ed infermiere. Il 35,6% (74/208) dei farmaci viene preparato da un operatore diverso da quello che lo somministra. I nodi critici del processo di lavoro risiedono in campi che sono degli infermieri ma anche di altri professionisti. Si può concludere affermando che tale indagine, pilota, è stata sicuramente utile per avere alcune informazioni generali sui processi di lavoro rispetto alla somministrazione farmacologica.
ABSTRACT
Administration of medication in an environment such as operating rooms is extremely complex and considerably increases the possibility of errors . This study was performed to analyze how medication is stored, prescribed and administered in operating rooms. Eight operating rooms in a Northern Italy hospital were taken into consideration, analyszing the medication prescribed in 96 working days. The critical points that emerged from the study regarded tasks performed by nurses , but also other professionals. This pilot study was useful for acquiring basic data on the working processes that surround the administration of medication.
Key words: medication safety, medication use process, operating room, perioperative nursing
Dettagli dell'articolo
Riferimenti
- Bemt, PM., Egberts, TC., Berg, J., Brouwers, JR. (2000). Drug-related problems in hospitalized patients. Drug Safety, 22(4), 321-33.
- Brady, AM., Malone, AM., Fleming, S. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17(6), 679-97.
- Calligaris, L., Panzera, A., Arnoldo, L., Londero, C., Quattrin, R., Troncom, M., Brusaferro, S. (2009). Errors and ommission in hospital prescription: a survey of prescription writing in a hospital. BioMed Central Clinical Pharmacology, (13), 9-9.
- Fontan, J., Maneglier, V., Nguyen, VX., Loirat, C., Brion, F. (2003). Medication errors in hospitals: computerized unit drug dispensing systems versus ward stock distribution system. Pharmacy World & Science, 25 (3), 112–117.
- Hicks, RW., Wanzer, L., Goeckner, B. (2011) Perioperative pharmacology: a framework for perioperative medication safety. American Operating Room Nursing Journal 93 (1): 136-145.
- Joint Commission on Accreditation of Healthcare Organizations. Standards for Hospitals. 3rd Edition. Data accesso 25 settembre, 20010. (2007). Da www.jointcommissioninternational.org/Accreditation-Manuals/JCI-STANDARDS-FOR-HOSPITALS-3RD-EDITION-EBOOK/491.
- Ovretveit, J., Sachs, MA. (2005). Patient safety and quality problems – what is the cost?. Lakartidningen, 102 (3), 140–142.
- Med Marx. (2008). A Report on the Relationship of Drug Names and Medication Errors in Response to the Institute of Medicine's Findings 2003-2006 and Trends 2002-2006.
- Palese, A., Sartor, A., Costaperaria, G., Bresadola, V. (2009). Interruptions during nurses' drug rounds in surgical wards:observational study. Journal of Nursing Management, 17, 185–192.
- Raccomandazione n. 7/2008 del Ministero della Salute. Raccomandazione per la prevenzione della morte, coma o grave danno derivato da errori in terapia farmacologica.
- Schedlbauer, A., Prasad, V., Mulvaney, C., Phansalkar, S., Stanton, W., Bates, DW., Avery, AJ. (2009). What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?. American Medical Informatics Association, 16(4):531-8.
- Smetzer, J. (2001). Take 10 Giant Steps to Medication Safety. Nursing, 31(11):49-53.
- Wanzer, LJ. (2005). Perioperative initiatives for medication safety. American Operating Room Nursing, 82 (4): 663-666.
- Wanzer, LJ., Hicks, RW. (2006). Medication safety within the perioperative environment Annual Revew of Nursing Research, 24, 127-155.
Riferimenti
Bemt, PM., Egberts, TC., Berg, J., Brouwers, JR. (2000). Drug-related problems in hospitalized patients. Drug Safety, 22(4), 321-33.
Brady, AM., Malone, AM., Fleming, S. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17(6), 679-97.
Calligaris, L., Panzera, A., Arnoldo, L., Londero, C., Quattrin, R., Troncom, M., Brusaferro, S. (2009). Errors and ommission in hospital prescription: a survey of prescription writing in a hospital. BioMed Central Clinical Pharmacology, (13), 9-9.
Fontan, J., Maneglier, V., Nguyen, VX., Loirat, C., Brion, F. (2003). Medication errors in hospitals: computerized unit drug dispensing systems versus ward stock distribution system. Pharmacy World & Science, 25 (3), 112–117.
Hicks, RW., Wanzer, L., Goeckner, B. (2011) Perioperative pharmacology: a framework for perioperative medication safety. American Operating Room Nursing Journal 93 (1): 136-145.
Joint Commission on Accreditation of Healthcare Organizations. Standards for Hospitals. 3rd Edition. Data accesso 25 settembre, 20010. (2007). Da www.jointcommissioninternational.org/Accreditation-Manuals/JCI-STANDARDS-FOR-HOSPITALS-3RD-EDITION-EBOOK/491.
Ovretveit, J., Sachs, MA. (2005). Patient safety and quality problems – what is the cost?. Lakartidningen, 102 (3), 140–142.
Med Marx. (2008). A Report on the Relationship of Drug Names and Medication Errors in Response to the Institute of Medicine's Findings 2003-2006 and Trends 2002-2006.
Palese, A., Sartor, A., Costaperaria, G., Bresadola, V. (2009). Interruptions during nurses' drug rounds in surgical wards:observational study. Journal of Nursing Management, 17, 185–192.
Raccomandazione n. 7/2008 del Ministero della Salute. Raccomandazione per la prevenzione della morte, coma o grave danno derivato da errori in terapia farmacologica.
Schedlbauer, A., Prasad, V., Mulvaney, C., Phansalkar, S., Stanton, W., Bates, DW., Avery, AJ. (2009). What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?. American Medical Informatics Association, 16(4):531-8.
Smetzer, J. (2001). Take 10 Giant Steps to Medication Safety. Nursing, 31(11):49-53.
Wanzer, LJ. (2005). Perioperative initiatives for medication safety. American Operating Room Nursing, 82 (4): 663-666.
Wanzer, LJ., Hicks, RW. (2006). Medication safety within the perioperative environment Annual Revew of Nursing Research, 24, 127-155.