Safe medicinal therapy: perspectives of nursing and pharmacy in patient care in the Intensive Care Unit (ICU)

Authors

DOI:

https://doi.org/10.33448/rsd-v10i6.15862

Keywords:

Nursing care; Clinical Pharmacy Service; Intensive Care Units; Medication Errors; Patient safety.

Abstract

In view of the alarming number of adverse events related to medications within the scope of the Intensive Care Unit (ICU), effective actions in patient care are necessary. In this perspective, this work aims to discuss the role of nursing and pharmacy regarding the safe use of medicines, aiming to guarantee the quality of care provided to critically ill patients. An integrative review of an exploratory-descriptive character with a qualitative approach was carried out, which resulted in the selection of 21 articles, published between January and April 2021, indexed in the main databases. From the studies analyzed, it was observed that the main adverse events were related to errors in prescription, preparation and administration; occurrence of drug interactions; incompatibilities between drugs and equipment. The emergence of these problems was associated with the communication failure of the multidisciplinary team, the work overload and the lack of knowledge about the pharmacodynamics and pharmacokinetics of the drug. Therefore, it is necessary to integrate and articulate nurses and pharmacists so that pharmacotherapy is effective, safe and assertive, due to the complexity projected in practice, demanding from these professionals greater qualification and training.

Author Biographies

Dayane Lins França, Centro de Educação Superior Dom Alberto LTDA

Specialist in Nursing in Intensive Care, Urgency and Emergency, from the Faculty of Technology of Curitiba (FATEC); - Specialist in Obstetric Nursing at the Faculty of Technology of Curitiba (FATEC); - Bachelor's Degree in Nursing from Faculdade Estácio de Sergipe (FASE); - Breastfeeding Consultant at Home Baby Assessoria. Experience in the Education Area, with emphasis on Coordination of technical nursing courses, acting mainly on the following themes: People and conflict management, situational strategic planning, continuing education and training of the teaching staff, meetings and standardization of the applied methodology and supervision of the laboratory and the equipment used in the course, provision of special materials, according to the contents taught and the particularities of the course, from the didactic plan of each discipline, preparation of Standard Operating Procedures (SOP) for laboratory techniques.

Tailaine Nascimento de Castro, State University of Bahia

Graduated in Pharmacy from Universidade Tiradentes (2017). Post-graduated in Clinical Pharmacology from Faculdade Futura (2018) and Pharmacy Hospital (2020) from Faculdade Venda Nova do Imigrante (FAVENI). Master's student in Line 1: Prospecting for drugs and natural resources in the Postgraduate Program in Pharmaceutical Sciences (PPGFARMA) at the State University of Bahia (UNEB), with a concentration in the areas of bioprospecting of natural assets; photoprotection and pharmacotechnical development of cosmetic products.

Valdjane Nogueira Noleto Nobre, CLMH do HC-UFMG/EBSERH

Graduated in Nursing from Faculdade Estácio Fase- Aracaju. Specialization in ICU, Urgency and Emargency, in Nephrology, Hospital management and people management. Acting with teaching in nursing and nephrologist nurse at the Hospital do Rim de Sergipe with a patient undergoing dialysis treatment. He is currently a member of the HOSPITAL DAS CLINICAS DE MINAS GERAIS, working mainly on the following topics: health and nursing.

References

Aparecida Maioli, N., Fernanda dos Santos Ferrari, A., Domingos dos Santos, T., & Cesar Barbosa Santos, H. (2018). Fast Hug: Uma Ferramenta Para Farmácia Clínica Na Atenção E Segurança Do Paciente Crítico. Colloquium Vitae, 10(2), 59–64. https://doi.org/10.5747/cv.2018.v10.n2.v233.

Arboit, É. L., Camponogara, S., Magnago, T. B. de S., Urbanetto, J. de S., Beck, C. L. C., & Silva, L. A. A. da. (2020). Factors contributing to the incident occurrence of security related to drug use in intensive care. Revista de Pesquisa Cuidado é Fundamental Online, 12, 1030–1036. https://doi.org/10.9789/2175-5361.rpcfo.v12.7456.

Borges, M. D., Correia, D. M. S., Hipólto, R. L., Christovam, B. P., Santo, F. H. E., Debora, K. V., & Batista, D. C. S. (2017). Pesquisa-ação com foco em cardiotônicos e interações para prática segura de enfermagem. Saude Coletiva, 49(09), 1644–1650.

Brasil, M. da S. (2013). Portaria n.529, de 1o de abril de 2013. Institui o Programa Nacional de Segurança do Paciente (PNSP). In Diário Oficial da União. https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html

Brasil. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada - RDC nº 36, de 25 de julho de 2013. Institui ações para a segurança do paciente em serviços de saúde e dá outras providências. Diário Oficial da União, Brasília, DF, 26 jul. 2013. p. 32.

Cedraz, K. N., & Junior, M. C. dos S. (2014). Identification and characterization of drug interactions in prescriptions of the intensive care unit of a public hospital in the city of Feira de Santana, BA. Rev Soc Bras Clin Med, 12(2), 124–130.

Chapuis, C., Chanoine, S., Colombet, L., Calvino-Gunther, S., Tournegros, C., Terzi, N., Bedouch, P., & Schwebel, C. (2019).

Interprofessional safety reporting and review of adverse events and medication errors in critical care

. Therapeutics and Clinical Risk Management, Volume 15, 549–556. https://doi.org/10.2147/TCRM.S188185

De Mello, J. F., & Barbosa, S. de F. F. (2013). Cultura de segurança do paciente em terapia intensiva: Recomendações da enfermagem. Texto e Contexto Enfermagem, 22(4), 1124–1133. https://doi.org/10.1590/S0104-07072013000400031

Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1), 1–9. https://doi.org/10.1186/s12913-019-4481-7

Farzi, S., Irajpour, A., Saghaei, M., & Ravaghi, H. (2017). Causes of medication errors in intensive care units from the perspective of healthcare professionals. Journal of Research in Pharmacy Practice, 6(3), 158. https://doi.org/10.4103/jrpp.jrpp_17_47

Fideles, G. M. A., De Alcântara-Neto, J. M., Júnior, A. A. P., De Souza-Neto, P. J., Tonete, T. L., Da Silva, J. E. G., & Neri, E. D. R. (2015). Pharmacist recommendations in an intensive care unit: Three-year clinical activities. Revista Brasileira de Terapia Intensiva, 27(2), 149–154. https://doi.org/10.5935/0103-507X.20150026

Gomes, M. J. V. de M., & Reis, A. M. M. (2003). Ciências Farmacêuticas Uma Abordagem em Farmácia Hospitalar (1 ed.). Atheneu.

Guzzo, G. M., de Magalhães, A. M. M., de Moura, G. M. S. S., & Wegner, W. (2018). Medication safety in neonatology: Nursing in the perspective of the ecological restorative approach. Texto e Contexto Enfermagem, 27(3), 1–10. https://doi.org/10.1590/0104-070720180004500016

Li, X. X., Zheng, S. Q., Gu, J. H., Huang, T., Liu, F., Ge, Q. G., Liu, B., Li, C., Yi, M., Qin, Y. F., Zhao, R. S., & Shi, L. W. (2020). Drug-Related Problems Identified During Pharmacy Intervention and Consultation: Implementation of an Intensive Care Unit Pharmaceutical Care Model. Frontiers in Pharmacology, 11. https://doi.org/10.3389/fphar.2020.571906

Martins, R. R., Silva, L. T., & Lopes, F. M. (2019). Impact of medication therapy management on pharmacotherapy safety in an intensive care unit. International Journal of Clinical Pharmacy, 41(1), 179–188. https://doi.org/10.1007/s11096-018-0763-0

Mazzola, P. G., Rodrigues, A. T., Da Cruz, A. A., De Marialva, M., Granja, S., Battaglini, S. C. M., Falcao, A. L. E., & Moriel, P. (2011). Artigo Original PERFIL E MANEJO DE INTERAÇÕES DRUG INTERACTIONS IN ICU PRESCRIPTIONS. Universidade Estadual de Campinas - UNICAMP, 2, 15–19.

Milani, A. C., De Oliveira Araujo, E., & Guimarães Polisel, C. (2018). Pharmacotherapeutic problems and pharmaceutical interventions in critical hospitalized patients. O Mundo Da Saúde, 42, 369–292. https://doi.org/10.15343/0104-7809.20184202369392

Okumura, L. M., da Silva, D. M., & Comarella, L. (2016). Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units. Revista Paulista de Pediatria (English Edition), 34(4), 397–402. https://doi.org/10.1016/j.rppede.2016.04.001

Pereira, A., Shitsuka, D., Parreira, F., & Shitsuka, R. (2018). Metodologia da Pesquisa Científica. In Metodologia da Pesquisa Científica (1a ed.). https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1. Acesso em: 28 março 2020.

Pilau, R., Hegele, V., & Heineck, I. (2014). Atuação do Farmacêutico Clínico em Unidade de Terapia Intensiva Adulto: Uma Revisão da Literatura. Rev. Bras. Farm. Hosp. Serv. Saúde São Paulo, 5(1), 19–24.

Reis, G. A. X. dos, Hayakawa, L. Y., Murassaki, A. C. Y., Matsuda, L. M., Gabriel, C. S., & Oliveira, M. L. F. de. (2017). Nurse Manager Perceptions of Patient Safety Strategy Implementation. Texto & Contexto - Enfermagem, 26(2), 1–9. https://doi.org/10.1590/0104-07072017000340016

Reis, M. A. S. dos, Gabriel, C. S., Zanetti, A. C. B., Bernardes, A., Laus, A. M., & Pereira, L. R. L. (2018). Medicamentos Potencialmente Perigosos : Identificação De Potentially Hazardous Drugs : Identification of Risks and Error Prevention Barriers in Intensive Care. Texto & Contexto - Enfermagem, 27(2), 1–9.

Ribeiro, V. F., Sapucaia, K. C. G., Aragão, L. A. O., Bispo, I. C. da S., Oliveira, V. F., & Alves, B. L. (2015). Realização de intervenções farmacêuticas por meio de uma experiência em farmácia clínica. Rev. Bras. Farm. Hosp. Serv. Saúde, 6(4), 18–22.

Siman, A. G., Tavares, A. T. D. V. B., Amaro, M. O. F., & Carvalho, C. A. de. (2021). Medication error: conceptions and behaviors of the nursing team members. Revista de Pesquisa Cuidado é Fundamental Online, 109–116. https://doi.org/10.9789/2175-5361.rpcfo.v13.7853

Storpirtis, S., Mori, A. L. P. M., Yochiy, A., Ribeiro, E., & Porta, V. (2013). Farmácia Clínica e Atenção Farmacêutica (Atheneu (ed.)).

Yunes, L. P., Coelho, T. de A., & De Almeida, S. M. (2011). Principais interações medicamentosas em pacientes da Uti-adulto de um hospital privado de Minas Gerais. R. Bras. Farm. Hosp. Serv. Saúde São Paulo, 2 n.3(61), 23–26. http://www.sbrafh.org.br/rbfhss/public/artigos/RBFHSSV2N3 artigo04.pdf

Downloads

Published

04/06/2021

How to Cite

FRANÇA, D. L.; CASTRO, T. N. de; NOBRE, V. N. N. Safe medicinal therapy: perspectives of nursing and pharmacy in patient care in the Intensive Care Unit (ICU). Research, Society and Development, [S. l.], v. 10, n. 6, p. e38410615862, 2021. DOI: 10.33448/rsd-v10i6.15862. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/15862. Acesso em: 21 nov. 2024.

Issue

Vol. 10 No. 6

Section

Health Sciences

License

Copyright (c) 2021 Dayane Lins França; Tailaine Nascimento de Castro; Valdjane Nogueira Noleto Nobre

Creative Commons License

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.