Dupla checagem de medicamentos potencialmente perigosos na Unidade de Terapia Intensiva

Abstract

To identify the potentially hazardous drugs (PHDs) used in the ICU that require double checking and to verify the perception of the nursing team regarding this routine. METHODS: Field, cross-sectional research, quantitative approach, descriptive design, with correlation between variables carried out in two units of a special-sized medical school hospital in northwestern São Paulo state. The study comprised three phases: the first, carried out by means of a survey of the drugs supplied by the pharmacy; these part of the double-checking routine. In the second, it has occurred through the researcher's participation during meetings with the medication safety group; attended by ICU Nurses, Pharmacists, Risk Manager, Assistant Superintendent, Nursing Service Manager, and the Continuing Education Nurse, whose objective was to verify how the double-checking routine was being carried out in the institution. In the third phase, a questionnaire was applied to nurses and Nursing technicians to assess the perception about double-checking regarding patient safety during the preparation and administration of PHDs, according to the current routine in the institution, with a sample of 125 professionals. The statistics were descriptive and inferential by Komolgorov-Smirnov and Mann Whitney Tests. RESULTS: A total of 97.6% of them were aware of the steps of the PHD double-checking process and recognized the importance of this routine to improve patient safety, corroborating the answer that should disagreed that this activity was only a bureaucracy faced by the Nursing team. In most cases, professionals with up to five years in the ICU performed the double-checking and were aware of all the steps to accomplish this routine. It was stood out that the most dispensed medication was Noradrenaline 21229 (37.5%), followed by Glucose 8066 (14.2%) and the least used was insulin NPH 35 (0.06%). As for the difficulties experienced in performing the routine, they pointed out the lack of time of both the nurse or nursing technician when preparing and administering the medications. CONCLUSION: The most commonly used PHDs that required double checking were: Noradrenaline, Glucose, Polymyxin, Heparin, and Vancomycin. The Nursing team´s conception about the double-checking routine is that it is an important barrier to avoid adverse events in medication, reflecting in the improvement of the patient safety. As an improvement strategy, there was a proposal to readjust the routine, adding to the instrument the description of the medications, mechanism of action, side effects and safe nursing care regarding preparation, administration and care, after installation, reevaluation of the MPP list and the withdrawal of medications: Polymyxin, Vancomycin and Glucose 50%, to facilitate the accomplishment and compliance of the double-checking routine by the ICU Nursing team. The impact of this study was to contribute to the reflection and adoption of measures to prevent errors in the administration of PHDs, with suggestions for the removal of some medications and the review of the double-checking process, thus allowing other hospitals to review their medication safety processes.