Improving quality of care and patients safety : Ready for use doses of drugs prepared by the pharmacy

M. Sassier1, M. Morisse 1, L. Ait Bouchrim 2, V. Chédru-Legros 1 1 Pharmacist, University hospital, 14000 Caen
2 Internal pharmacist, University hospital, 14000 Caen

Introduction

A serious adverse event occurs on average every 5 days in a 30 beds department (ENEIS survey 2009). Among them, the medication errors can be due to errors in drugs preparation.

A survey was led by pharmacy and hospital care direction to question nurses about current and future needs about ready for use doses of drugs who could be prepared by the pharmacy. The objective is to improve quality and safety of patient’s care management.

Material and Method

Survey was led in May 2011, from a validated written questionnaire, with mainly closed answers. It was sent to nurses of medicine, surgery, emergency and intensive care departments. Four domains were targeted : improving pain management, prevention of serious adverse events, care risk management and nosocomial infections prevention.

Results

Data were collected in June 2011, 66 questionnaires were returned and exploited. They came from 35 clinical units on a total of 72.

Medicine and surgery departments are applicants to ready for use opioids cartridge preparations (78 % of requests). Carcinogen, mutagen and reprotoxic substances (antiviral, immunosuppressive and antineoplastic) are quoted in 86 % of the cases. Narrow therapeutics drugs represent 54 % of requests (norepinephrine, adrenaline, dobutamine and dopamine). Drugs preparations with double dilution, complex calculations, high risk of preparation error represent 55 % of requests, especially in emergencies departments. Drugs for emergencies are cited in 70% of the cases (adrenaline, atropine and ephedrine syringes for the emergency trolley).

Discussion – Conclusion

Injectable drugs cause main errors and serious adverse drug events. IGAS (General Inspection of Social Affairs) report about drug circuit published in May 2011, recommends “centralization of the high-risk medications, like what’s already made for chemotherapy preparations”.

Priorities concerning pharmaceutical preparation must be established and accompanied with adequate resources in particular through automation of preparations.

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