María Cruz Martín and María José Otero.
Article ‘Evaluation of the implementation of safe practices with drugs in Intensive Medicine Services’, published in the latest issue of the magazine Intensive Medicine, is the first document signed jointly by hospital intensivists and pharmacists that is committed to the incorporation of barcodes in medicines, the generalization of the electronic prescription integrated and the incorporation of specialist pharmacist in ICUs to reduce medication errors, adverse events, and mortality.
The data Collect, which began in March 2020, was very well received despite the situation arising from the Covid-19 pandemic, which highlighted the interest of health professionals from both specialties in improving safety.
For María Cruz Martín, head of the Intensive Medicine Service of the Torrejón University Hospital and responsible for the study by the Spanish Society of Intensive, Critical Medicine and Coronary Units (Semicyuc), “The information provided by this study will be very useful to plan improvement actions in the areas that may be of greatest interest to work together by the SEFH and Semicyuc, in order to advance effectively in the critical patient safety”.
The study was carried out as a result of an agreement signed between both companies in which it was established as a priority line of collaboration to work together in the improving the safety of medication in critically ill patients, since these patients are at very high risk of suffering from avoidable adverse events by medicines. These activities are in line with the strategic objectives of the World Health Organization’s Global Patient Safety Action Plan 2021-2030.
In the first place, a questionnaire was developed for the Intensive Care Medicine services to evaluate the medication safety, with the participation of ISMP-Spain and the support of the Ministry of Health. In this way, the Intensive Medicine services had a specific continuous improvement tool which would help them analyze the safety of their medication practices and identify their critical risk points and opportunities for improvement. Next, the realization of this study was proposed to know the situation of the safety of the process of use of medicines in the Intensive Care Services nationwide, in which the participants participated 40 services nationwide.
Results and future outlook
The work has shown that there are numerous possibilities for improvement that need to be addressed to reduce the avoidable adverse events by medication in critically ill patients. Although differences were observed in the degree of implementation of various practices between the services, the information collected has revealed that there are also numerous effective safe practices of proven efficacy whose implementation is low or very scarce in our country.
According to María José Otero, head of the Pharmacy service of the Salamanca University Hospital, director of the ISMP-Spain and coordinator of the study by the SEFH: “These practices include the incorporation of new technologies, particularly the barcode in administration, whose incorporation is anecdotal, but also the availability of integrated electronic prescription and clinical decision support systems, or intelligent infusion pumps, which are clearly insufficient. The data indicate that the incorporation of the clinical pharmacist to the multidisciplinary intensive teams is very low, when the evidence supports that this reduces errors, adverse events and mortality ”.
The authors of the article highlight that, according to their experience, “with this type of studies that are based on the use of self-assessment tools, We believe that carrying out the study has promoted the use of the questionnaire and, with this, that professionals review their processes and discuss the safe practices for the use of medicines in their services, which ultimately encourages them to undertake improvement measures in the centers ”.
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