Safety in the administration of injectable medications: Scoping review
Keywords:Patient safety; Risk management; Medication systems, hospital; Medication errors; Technology; Clinical Protocols.
Objective: to raise scientific evidence on technologies for the safe administration of injectable drugs in hospitalized adult patients. Method: this is a study of the Scoping Review type, using the crossing of the descriptors Patient Safety, Medication Errors and Technology in the following databases: Medical Literature Analysis and Retrieval System Online Electronic Library Online, Science Direct, Virtual Health Library, Pubmed, Web of Science and Scopus. The choice of studies included in the sample and data extraction occurred in a paired manner by independent researchers. Results: 14 studies were classified as eligible. The interventions found were medication administration using a barcode, patient identification by plates, bracelets, radiofrequency and/or biometrics, personal digital assistants, mobile nursing carts, electronic medication administration record, safety syringe system based on key-lock adapters, smart infusion pumps, drugs organizer kits, storage bag, trays with dividers, adhesive in different colors for separating medicines by class, and double checking. Final considerations: The implementation of technologies, professionalism, changes in the organization and in the workplace linked to the empowerment of the patient and family/companion enables the quality of the injectable medication administration processes. It is considered an advantageous investment in technologies for the culture of safety.
Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, volume 38(12), pages 1173–1180. DOI: https://doi.org/10.15537/smj.2017.12.20631
Brazil. (2013). Protocolo de Segurança na Prescrição, Uso e Administração de Medicamentos. Protocolo coordenado pelo Ministério da Saúde e ANVISA em parceria com FIOCRUZ e FHEMI. Retrieved October 10, 2019, from https://portalarquivos2.saude.gov.br/images/pdf/2014/julho/03/Protocolo-Medicamentos.pdf
Brazil. (2014). Documento de referência para o Programa Nacional de Segurança do Paciente. Retrieved October 10, 2019, from http://bvsms.saude.gov.br/bvs/publicacoes/documento_referencia_programa_nacional_seguranca.pdf
Brazil. (2014). Diretrizes metodológicas: Sistema GRADE – Manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde. Retrieved October 10, 2019, from http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_metodologicas_sistema_grade.pdf
Burkoski, V., Yoon, J., Solomon, S., Hall, T. N. T., Karas, A. B., Jarrett, S. R., & Collins, B. E. (2019a). Closed-Loop Medication System: Leveraging Technology to Elevate Safety. Nursing Leadership (Toronto, Ont.), volume 32(SP), pages 16–28. DOI: https://doi.org/10.12927/cjnl.2019.25817
Cho, Y. C., Lee, S. H., Cho, Y. H., & Choy, Y. B. (2017). Adapter-based Safety Injection System for Prevention of Wrong Route and Wrong Patient Medication Errors. Journal of Korean Medical Science, volume 32(12), pages1938–1946. DOI: https://doi.org/10.3346/jkms.2017.32.12.1938
Debono, D., Taylor, N., Lipworth, W., Greenfield, D., Travaglia, J., Black, D., & Braithwaite, J. (2017). Applying the Theoretical Domains Framework to identify barriers and targeted interventions to enhance nurses’ use of electronic medication management systems in two Australian hospitals. Implementation Science, volume 12(1), 42. DOI: https://doi.org/10.1186/s13012-017-0572-1
Franciscatto, L., Bessow, C., Ruzczyk, J., Oliveira, M., & Kluck, M. (2012). Metas internacionais de segurança do paciente em hospital universitário. Clinical & Biomedical Research, volume 31(4), pages 482-486. Retrieved October 15, 2019, from https://seer.ufrgs.br/hcpa/article/view/21146/14967
Franz, R., Robertson, S., Spiro, S., Ramirez, D., McEvoy, G., Thompson, S., Clayman, A. E., Graeff, C. C., Mankad, H., Baird, J., Suko, J., Galati, K., Recchiuti, K., Gatsos-Walter, J. A., Benjamin, P., Ebert, R., Callinan, S., & Henderson, T. (2016). NCPDP recommendations for dose accumulation monitoring in the inpatient setting: Acetaminophen case model, version 1.0. American Journal of Health-System Pharmacy, volume 73(15), pages 1144–1165. DOI: http://doi.org/10.2146/ajhp160215
Gimenes, F. (2016). Administração: Não basta usar, é preciso conhecer a maneira correta. In: Uso Racional de Medicamentos: fundamentação em condutas terapêuticas e nos macroprocessos da Assistência Farmacêutica. Brasília: OPAS/OMS
JBI (Joanna Briggs Institute). (2015) Methodology for JBI Scoping Reviews -Joanna Briggs 2015. Australia: JBI; c2015. Retrieved March 25, 2020, from https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Scoping.pdf
Magalhães, A. M. M. de, Moura, G. M. S. S. de, Pasin, S. S., Funcke, L. B., Pardal, B. M., & Kreling, A. (2015). Processos de medicação, carga de trabalho e a segurança do paciente em unidades de internação. Rev. Esc. Enferm. USP, volume 49(spe), pages 43–50. DOI: https://doi.org/10.1590/S0080-623420150000700007
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G. (2009). Preferred Reporting Items for Systematic Reviews and Meta Analyses: The PRISMA Statement. PLoS Medicine, volume 6(7), e1000097. DOI: http://doi.org/10.1016/j.jclinepi.2009.06.005
OPAS (Organização Panamericana de Saúde). (2017). OMS lança esforço global para reduzir pela metade os erros relacionados à medicação em cinco anos. Retrieved November 28, 2019, from https://www.paho.org/bra/index.php?option=com_content&view=article&id=5384:oms-lanca-esforco-global-para-reduzir-pela-metade-os-erros-relacionados-a-medicacao-em-cinco-anos&Itemid=838
Orbæk, J., Gaard, M., Fabricius, P., Lefevre, R. S., & Møller, T. (2015). Patient safety and technology-driven medication—A qualitative study on how graduate nursing students navigate through complex medication administration. Nurse Educ Pract, volume 15(3), pages 203–211. DOI: https://doi.org/10.1016/j.nepr.2014.11.015
Peters, M. D. J., Godfrey C., McInerney P., Munn Z., Tricco A. C. & Khalil H. (2020). JBI Manual for Evidence Synthesis. Chapter11: Scoping Reviews Retrieved April 6, 2020, from https://doi.org/10.46658/JBIMES-20-12
Peterson, J., Pearce, P. F., Ferguson, L. A., & Langford, C. A. (2017). Understanding scoping reviews: Definition, purpose, and process. Journal of the American Association of Nurse Practitioners, volume 29 (1), pages 12–16. DOI: http://doi.org/10.1002/2327-6924.12380
Ramos, R. da S., Pina, R. M. P. ., Neves, J. C. ., Moura, G. da S. ., & Oliveira, H. M. de . (2021). O protagonismo de usuários em um hospital escola no Amazonas: Percepção acerca da segurança do paciente. Research, Society and Development, volume 10(3), e37510313597. https://doi.org/10.33448/rsd-v10i3.13597
Risør, B. W., Lisby, M., & Sørensen, J. (2017). Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, volume 20(7), pages 886–893. DOI: https://doi.org/10.12927/cjnl.2019.25817
Shah, K., Lo, C., Babich, M., Tsao, N. W., & Bansback, N. J. (2016). Bar code medication administration technology: A systematic review of impact on patient safety when used with computerized prescriber order entry and automated dispensing devices. Canadian Journal of Hospital Pharmacy, volume 69 (5), pages 394–402. DOI: https://doi.org/10.12927/cjnl.2019.25817
Shola, U. R., & Neela Narayanan, V. (2017). A review on patient-controlled analgesia infusion system. Asian Journal of Pharmaceutical and Clinical Research, volume 10, pages 117–121. DOI: https://doi.org/10.12927/cjnl.2019.25817
Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., Storlie, C. B., Johnson, M. G., & Naessens, J. M. (2018). Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342–351. DOI: https://doi.org/10.12927/cjnl.2019.25817
Uy, R. C. Y., Kury, F. P., & Fontelo, P. A. (2015). The State and Trends of Barcode, RFID, Biometric and Pharmacy Automation Technologies in US Hospitals. AMIA Annual Symposium Proceedings, 1242–1251. Retrieved April 6, 2020, from: https://www.researchgate.net/publication/299389487_The_State_and_Trends_of_Barcode_RFID_Biometric_and_Pharmacy_Automation_Technologies_in_US_Hospitals
Vilela, R. P. B., & Jericó, M. C. (2019). Implementing technologies to prevent medication errors at a high-complexity hospital: Analysis of cost and results. Einstein (São Paulo), volume 17(4), eGS4621. DOI: http://doi.org/10.31744/einstein_journal/2019GS4621
Wang, H. F., Jin, J. F., Feng, X. Q., Huang, X., Zhu, L. L., Zhao, X. Y., & Zhou, Q. (2015). Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: A trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. Therapeutics and Clinical Risk Management, volume 11, pages 393–406. DOI: https://doi.org/10.12927/cjnl.2019.25817
How to Cite
Copyright (c) 2021 Andre Nascimento Honorato Gomes; Ramayana Soares da Silva; Eliana Brasil Alves; Graziela da Silva Moura; Hadelândia Milon de Oliveira
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.