Prevalence and factors associated with incidents related to medication in surgical patients

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Abstract

The aim of this study was to estimate the prevalence and factors associated with the occurrence of incidents related to medication, registered in the medical records of patients admitted to a Surgical Clinic, in 2010. This is a cross-sectional study, conducted at a university hospital, with a sample of 735 hospitalizations. Was performed the categorization of types of incidents, multivariate analysis of regression logistic and calculated the prevalence. The prevalence of drug-related incidents was estimated at 48.0% and were identified, as factors related to the occurrence of these incidents: length of hospitalization more than four days, prescribed three or more medications per day and realization of surgery intervention. It is expected to have contributed for the professionals and area managers can identify risky situations and rethink their actions.

Translated abstract

Estudo de corte transversal, conduzido em um hospital universitário, com amostra de 735 internações, cujo objetivo foi estimar a prevalência e os fatores associados à ocorrência de incidentes relacionados à medicação, registrados em prontuários de pacientes internados em uma clínica cirúrgica no ano de 2010. Foi realizada a categorização dos tipos de incidentes com apresentação das frequências absoluta e relativa, calculada a prevalência e realizada análise multivariada. A prevalência dos incidentes relacionados à medicação foi estimada em 48,0% e identificaram-se como fatores relacionados a sua ocorrência o tempo de internação igual ou superior a quatro dias, a prescrição de três ou mais medicamentos por dia e a realização de intervenção cirúrgica. Espera-se ter contribuído para que os profissionais e gestores da área possam identificar situações de risco e repensar sua atuação.

Translated abstract

Estudio de corte transversal, realizado en un Hospital docente, con una muestra de 735 internaciones, cuyo objetivo fue estimar la prevalencia y los factores asociados a la ocurrencia de incidentes relacionados a la medicación, registrados en las historias clínicas de los pacientes hospitalizados en el Servicio de Cirugía, en el año de 2010. Se realizó la categorización de los tipos de incidentes y fueron presentados la frecuencia absoluta y relativa, calculando la prevalencia y realizando el análisis multivariante. La prevalencia de los incidentes relacionados a la medicación se estimó en 48,0% y fueron identificados como factores relacionados a la ocurrencia de estos incidentes: tiempo de la hospitalización igual o superior a cuatro días, prescripción de tres o más medicamentos por día y realización de la intervención quirúrgica. Se espera haber contribuido para que los profesionales y administradores del área puedan identificar situaciones de riesgo y revisar su actuación.

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Most cited references 44

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Analysis of risk factors for adverse drug events in critically ill patients*.

L Kirisci, M Verrico, M Rothschild … (2012)

An evaluation of risk factors for adverse drug events in critically ill patients has not been previously studied. The purpose of this original study was to determine risk factors for adverse drug events in critically ill adult patients. This retrospective case-control study includes patients who were admitted to the intensive care unit during a 7.5-yr period. Academic medical center with 647 beds that contains approximately 120 intensive care unit beds. Patients in the case group experienced an adverse drug event as documented in the hospital's database. The control group comprised the next two patients admitted to the same intensive care unit by the same admitting service. None. Twenty-nine suspected risk factors identified from the literature were evaluated, including patient characteristics, drug characteristics, and laboratory values using a multiple logistic regression. A sample of 1101 cases and controls (54% male), with a mean age of 59.4 ± 17.5 yrs, were identified. In 367 cases, there was a total of 499 documented adverse drug events. Patients with kidney injury, thrombocytopenia, and those admitted emergently were 16-times, 3-times, and 2-times more likely to have an adverse drug event, respectively. Patients who were administered intravenous medications had a 3% higher risk of having an adverse drug event for each drug dispensed. Overall, the case group received more drugs per intensive care unit day and more drugs per intensive care unit stay. Several patient and drug-related characteristics contribute to the risk of adverse drug events in critically ill patients. Diligent monitoring of factors that can influence the pharmacokinetic properties for existing drug therapies is necessary. Drug regimens should be evaluated daily for minimization. Based on previous studies, pharmacists as part of the interdisciplinary team could help to manage these risks.

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Ottawa Hospital Patient Safety Study: incidence and timing of adverse events in patients admitted to a Canadian teaching hospital.

Kevin P. Baker, Jim Worthington, James Watters … (2004)

Adverse events are poor patient outcomes that are due to medical care. Studies of hospital patients have demonstrated that adverse events are common, but few data describe the timing of them in relation to hospital admission. We evaluated characteristics of adverse events affecting patients admitted to a Canadian teaching hospital, paying particular attention to timing. We randomly selected 502 adults admitted to the Ottawa Hospital for acute care of nonpsychiatric illnesses over a 1-year period. Charts were reviewed in 2 stages. If an adverse event was judged to have occurred, a physician determined whether it occurred before or during the index hospitalization. The reviewer also rated the preventability, severity and type of each adverse event. Of the 64 patients with an adverse event (incidence 12.7%, 95% confidence interval [CI] 10.1%-16.0%), 24 had a preventable event (4.8%, 95% CI 3.2%-7.0%), and 3 (0.6%, 95% CI 0.2%-1.7%) died because of an adverse event. Most adverse events were due to drug treatment, operative complications or nosocomial infections. Of the 64 patients, 39 (61%, 95% CI 49%-72%) experienced the adverse event before the index hospitalization. Adverse events were common in this study. However, only one-third were deemed avoidable, and most occurred before the hospitalization. Interventions to improve safety must address ambulatory care as well as hospital-based care.

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National study on the distribution, causes, and consequences of voluntarily reported medication errors between the ICU and non-ICU settings.

Asad Latif, Nishi Rawat, Aliaksei Pustavoitau … (2013)

To compare the distribution, causes, and consequences of medication errors in the ICU with those in non-ICU settings.

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Author and article information

Contributors

Thatianny Tanferri de Brito Paranaguá: Role: ND

Ana Lúcia Queiroz Bezerra: Role: ND

Andressa Luanna Moreira dos Santos: Role: ND

Ana Elisa Bauer de Camargo Silva: Role: ND

Journal

Journal ID (publisher): reeusp

Title: Revista da Escola de Enfermagem da USP

Abbreviated Title: Rev. esc. enferm. USP

Publisher: Universidade de São Paulo, Escola de Enfermagem (São Paulo )

ISSN: 1980-220X

Publication date (Print): February 2014

Volume: 48

Issue: 1

Pages: 41-47

Affiliations

[1 ] Universidade Federal de Goiás Brazil

[2 ] Universidade Federal de Goiás Brazil

[3 ] Universidade Federal de Goiás Brazil

[4 ] Universidade Federal de Goiás Brazil

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Publisher ID: S0080-62342014000100041

DOI: 10.1590/S0080-623420140000100005

SO-VID: 782e5b7e-a72a-4f5e-b88a-36ae23c92edc

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http://creativecommons.org/licenses/by/4.0/

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Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0080-6234&lng=en

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Most cited references 44

Analysis of risk factors for adverse drug events in critically ill patients*.

Ottawa Hospital Patient Safety Study: incidence and timing of adverse events in patients admitted to a Canadian teaching hospital.

National study on the distribution, causes, and consequences of voluntarily reported medication errors between the ICU and non-ICU settings.

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