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      Análisis de errores con medicamentos en pacientes ingresados en salas de cirugía y recuperación posanestésica de un hospital de alta complejidad en Bogotá, Colombia Translated title: An analysis of medication errors in patients admitted to surgery rooms and post-anesthetic recovery at a high-complexity hospital in Bogota, Colombia

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          Abstract

          RESUMEN Los errores con medicamentos representan una de las principales causas de incidentes y eventos adversos durante el periodo perioperatorio por lo que en este estudio se analizaron los errores antes, durante y después de la administración de anestesia general para la realización de cirugía abdominal en un hospital de alta complejidad en Bogotá, Colombia. Se realizó un estudio descriptivo de corte transversal en 390 pacientes entre los meses de enero a septiembre de 2019. De las 3.677 administraciones de medicamentos, en el 60% se incurrió en algún tipo de error, mayoritariamente en cirugías de urgencia. El grupo farmacológico con más errores fue el de los anestésicos generales con un 32%. Todos los errores identificados se configuraron como situaciones con potencial de daño lo que indica la necesidad de promover la estandarización de actividades durante la utilización de medicamentos y la cultura de seguridad asistencial para evitar que ocasionen eventos adversos.

          Translated abstract

          ABSTRACT Medication errors represent one of the main causes of incidents and adverse events during the perioperative period. Therefore, this study analyzes errors before, during, and after the administration of general anesthesia for abdominal surgery at a high-complexity hospital in Bogota, Colombia. A descriptive cross-sectional study was conducted with 390 patients between January and September 2019. Of the 3,677 medication administrations, some type of error was made in 60% of cases, mostly in emergency surgeries. The pharmacological group with the most errors was general anesthetics, with 32%. All identified errors constituted situations with harm potential, indicating the need to promote the standardization of activities involving the use of medications and a culture of healthcare safety in order to avoid adverse events.

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          Most cited references85

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          To Err Is Human : Building a Safer Health System

          (2000)
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            The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection.

            Randomized, controlled trials have shown that prophylactic antibiotics are effective in preventing surgical-wound infections. However, it is uncertain how the timing of antibiotic administration affects the risk of surgical-wound infection in actual clinical practice. We prospectively monitored the timing of antibiotic prophylaxis and studied the occurrence of surgical-wound infections in 2847 patients undergoing elective clean or "clean-contaminated" surgical procedures at a large community hospital. The administration of antibiotics 2 to 24 hours before the surgical incision was defined as early; that during the 2 hours before the incision, as preoperative; that during the 3 hours after the incision, as perioperative; and that more than 3 but less than 24 hours after the incision, as postoperative. Of the 1708 patients who received the prophylactic antibiotics preoperatively, 10 (0.6 percent) subsequently had surgical-wound infections. Of the 282 patients who received the antibiotics perioperatively, 4 (1.4 percent) had such infections (P = 0.12; relative risk as compared with the preoperatively treated group, 2.4; 95 percent confidence interval, 0.9 to 7.9). Of 488 patients who received the antibiotics postoperatively, 16 (3.3 percent) had wound infections (P less than 0.0001; relative risk, 5.8; 95 percent confidence interval, 2.6 to 12.3). Finally, of 369 patients who had antibiotics administered early, 14 (3.8 percent) had wound infections (P less than 0.0001; relative risk, 6.7; 95 percent confidence interval, 2.9 to 14.7). Stepwise logistic-regression analysis confirmed that the administration of antibiotics in the preoperative period was associated with the lowest risk of surgical-wound infection. We conclude that in surgical practice there is considerable variation in the timing of prophylactic administration of antibiotics and that administration in the two hours before surgery reduces the risk of wound infection.
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              The Helsinki Declaration on Patient Safety in Anaesthesiology.

              Anaesthesiology, which includes anaesthesia, perioperative care, intensive care medicine, pain therapy and emergency medicine, has always participated in systematic attempts to improve patient safety. Anaesthesiologists have a unique, cross-specialty opportunity to influence the safety and quality of patient care. Past achievements have allowed our specialty a perception that it has become safe, but there should be no room for complacency when there is more to be done. Increasingly older and sicker patients, more complex surgical interventions, more pressure on throughput, new drugs and devices and simple chance all pose hazards in the work of anaesthesiologists. In response to this increasingly difficult and complex working environment, the European Board of Anaesthesiology (EBA), in cooperation with the European Society of Anaesthesiology (ESA), has produced a blueprint for patient safety in anaesthesiology. This document, to be known as the Helsinki Declaration on Patient Safety in Anaesthesiology, was endorsed by these two bodies together with the World Health Organization (WHO), the World Federation of Societies of Anaesthesiologists (WFSA), and the European Patients' Federation (EPF) at the Euroanaesthesia meeting in Helsinki in June 2010. The Declaration represents a shared European view of that which is worthy, achievable, and needed to improve patient safety in anaesthesiology in 2010. The Declaration recommends practical steps that all anaesthesiologists who are not already using them can successfully include in their own clinical practice. In parallel, EBA and ESA have launched a joint patient safety task-force in order to put these recommendations into practice. It is planned to review this Declaration document regularly.
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                Author and article information

                Journal
                sc
                Salud colectiva
                Salud colect.
                Universidad Nacional de Lanús (Lanús, Buenos Aires, Argentina )
                1669-2381
                1851-8265
                2021
                : 17
                : e3155
                Affiliations
                [2] orgnameUniversidad Nacional de Colombia Colombia jjlopezg@ 123456unal.edu.co
                [1] Bogotá orgnameUniversidad Surcolombiana Colombia avillanueva@ 123456unal.edu.co
                Article
                S1851-82652021000100406 S1851-8265(21)01700000406
                10.18294/sc.2021.3155
                12d274b0-6418-46f0-98ee-862b8c53dd3a

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 08 September 2020
                : 01 March 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 87, Pages: 0
                Product

                SciELO Public Health

                Categories
                Artículos

                Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos,Colombia,Medication Errors,Operating Room,Patient Safety,Drug-Related Side Effects and Adverse Reactions,Errores de Medicación,Quirófanos,Seguridad del Paciente

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