Enfermagem e segurança na terapia medicamentosa em unidades intensivas

Abstract

The purpose of this study is the medicine care management by the nursing in the patients safety view in intensive care. The research issue was: Are there any mistakes and/or situations which can help the mistakes occurrence over the storage stages, the place of preparation, the preparation and the medicine dispensing by the nursing staff in the intensive care? The objective were: a) to identify the situation which facilitated the mistakes in the storage stages, the place of preparation, the preparation and the medicine dispensing in the intensive care; b) to analyze the mistakes occurrence over the storage stages, the place of preparation, the preparation and the medicine dispensing associated to the nursing staff in the intensive care. This work justified itself by the nursing assume, in the management view of the medicine therapy, the search for the quality in care, translated into a safe practice, allowing the quick recovery of the patient. The theoretical reference were a medicine and a mistake of medicine system. Study exploratory, observational, with quantitative approach undertaken in the Pro - Cardiac Hospital in three ICUs: Coronary Unit (UCOR), ICU, Post-Operative (UPO) and General intensive care units (ICU). Population: 45 nurses and 44 technical nursing observed in the preparation and the dispensing of the medication, characterized by: female dominance in the nurse category (84.4%) and males in the technicians (52.3%), the mean age was 32 years old (± 5.76) in the nurses group and 35 years old (± 6.97) in the technical nursing group; the average in the nursing performance was 9 years (± 5.53) in the group of nurses and 13 years (± 6.58) in the group of technicians; an average of 8 years (± 4.35) in ICU performance in the group of nurses and 10 years (± 6.07) in the group of technicians. The results indicate the principal situations that facilitate the medicine mistake with intravenous drug: noisy environment of preparation (68%) does not explain the procedure to the patient (64%) and the dispensing of the medicine in verbal order (40%). For oral drugs: noisy environment of preparation (55%) does not explain the procedure to the patient (52%) and more than 1 professional at the preparation place (45%). Regard to the mistakes in medication with intravenous drug were found: not selective and orderly storage of medicines (100%), lack of protocols for all injecting drug (100%). In oral drugs: not selective and orderly storage of medicinal products (100%), lack of registration of medicine dispensed (48%) and delays in the dispensing (34%). Final considerations: the study of the facilitated situations of the mistakes occurrence and the mistakes in medication in the intensive care context can contribute to the implementation of practical and effective actions aimed to achieve an assistance of nursing which focus on the safety of the patient. Besides allowing to highlight the environmental and systemic factors that may influence in the medicine dispensing.