Uso de medicamentos parenterales en frascos-ampolla en un servicio pediátrica de un hospital universitario

This observational study aimed to determine the frequency of utilization of vials containing parenteral medications in a pediatric unit, and to identify nursing team actions related to their preparation and administration. Data were collected from prescription forms and by checking these drugs in the refrigerator and stocks at the unit. Vials were prescribed to 30.8% of patients. Aspects such as: reconstitution, storage, temperature and drug label were observed. Only 6.8% of the drugs had all the information researched in order to evaluate the process of preparation and administration. The correct identification of vials is important for the safe use of medication. Training programs for the healthcare team and the adoption of intravenous therapy guidelines are essential tools to optimize the utilization of parenteral medication.Este estudio de observación determinó la frecuencia para utilizar medicamentos parenterales en frascos-ampolla en una unidad pediátrica, identificando las acciones del equipo de enfermería con respecto a su preparación y administración. Para la recolección de datos se utilizó la prescripción médica y la observación directa de los medicamentos en los frigideres y estantes del servicio. La presentación en frascos-ampolla fue prescripta en 30.8% de los pacientes. Se observó la reconstitución, el almacenamiento, la temperatura y los rótulos de los medicamentos, factores importantes para asegurar su administración. Las informaciones investigadas para evaluar el proceso de preparación y administración estuvieron presentes en apenas 6.8% de los medicamentos. La correcta identificación de los frascos-ampolla es importante para su administración. El entrenamiento del equipo de salud y la adopción de directrices sobre tratamiento endovenoso son instrumentos esenciales para optimizar la utilización del medicamento parenteral.Este estudo observacional determinou a freqüência de utilização de medicamentos parenterais em frascos-ampola em uma unidade pediátrica, e identificou as ações da equipe de enfermagem associadas ao preparo e administração desses medicamentos. Os dados foram coletados por meio da prescrição médica e observação direta dos medicamentos nas geladeiras e armários da unidade. A apresentação em frascos-ampola foi prescrita para 30,8% dos pacientes. Foram observados aspectos quanto à reconstituição, ao armazenamento, à temperatura e à rotulagem dos medicamentos, fatores importantes para utilização segura dos mesmos. As informações pesquisadas para avaliar o processo de preparo e de administração estavam todas presentes em apenas 6,8% dos medicamentos. A identificação correta dos frascos-ampola é importante para o uso seguro dos medicamentos. O treinamento da equipe de saúde e a adoção de diretrizes de terapia endovenosa são instrumentos essenciais para otimizar o processo de utilização de medicamentos parenterais

Study utilization of parenteral medications in pediatric unit of universitary hospital

A administração de medicamentos parenterais tem grande importância na assistência pediátrica e no risco para aquisição de infecções hospitalares. Este estudo observacional transversal visou descrever a utilização de medicamentos em uma unidade de internação pediátrica. Elaborou-se um instrumento de coleta de dados, as variáveis relativas à farmacoterapia foram coletadas da prescrição médica e a análise estatística descritiva foi realizada no SPSS. A amostra foi constituída de 75 pacientes pediátricos, sendo 56,0 % do sexo masculino; apresentando como predominante a faixa etária de lactentes. O tempo de internação mais freqüente foi maior que 20 dias (24,0%) seguida de 6 a 10 dias (21,3%) e menos de 3 dias (17,3%). A via parenteral foi prescrita para 56 pacientes (74,7%) e 19 (25,3%) utilizaram outras vias ou não utilizaram medicamentos; sendo que a via parenteral endovenosa foi utilizada por 52 (92,9%) dos pacientes. O número de medicamentos parenterais prescritos abrangeu 47 fármacos. A média do número de medicamentos por paciente foi quatro, o que implica em exigência de maior tempo da equipe de enfermagem em atividades relacionadas à administração de medicamentos. O número elevado de medicamentos prescritos desperta preocupações em relação à segurança. O farmacêutico deve estimular a conversão da via de administração parenteral para a oral.Parenteral drug administration has clinical relevance in pediatric care and the risk of acquire nosocomial infection. The purpose of this observational cross-sectional study was to describe the utilization of parenteral drugs in a pediatric unit. A research questionnaire was created. The variables about pharmacotherapy were collect in prescriptions. The descriptive statistical analysis was performed using SPSS A total of 75 patients were admitted, 56% were male. The age range most frequently was the infants. The length of hospitalization was over 20 days (24.0%), 6 to 10 days (21.3%) and less than 3 days (17.3%). Parenteral route was used to 56 (74.7%) patients, so 19 (25.3%) used other routes or did not use medicine. Intravenous route was used to 52 (92.9%) patients. Overall, 47 different parenteral drugs were prescribed . The average of 4 drugs per patient requires more time of nursing team in activities related with drug administration. The high number of drug prescribed per patient raise concern about safety. The pharmacist should stimulate conversion from parenteral to oral administration

Perfil clínico e funcional do idoso atendido no Centro Mais Vida do Hospital das Clínicas da Universidade Federal de Minas Gerais, Brasil, 2011

Exportado OPUSMade available in DSpace on 2019-08-10T20:20:30Z (GMT). No. of bitstreams: 1 disserta__o_final_marta_para_impressao_25__outubro_c_pia_2.pdf: 2190914 bytes, checksum: ce83fb1d8163e0abd22110836cecf9f5 (MD5) Previous issue date: 21Objetivos: caracterizar o perfil clínico e funcional de amostra de idosos atendidos no Centro Mais Vida do Hospital das Clínicas da Universidade Federal de Minas Gerais, no período de dezembro de 2011 a novembro de 2012. Material e Métodos: trata-se de estudo descritivo, transversal cuja amostra constou de 894 idosos. Foram analisadas as variáveis sexo, idade, escolaridade e funcionalidade global, considerando a cognição, humor, mobilidade e comunicação. Também foram analisadas as doenças e condições de saúde mais frequentes, o número de medicamentos utilizados e de encaminhamentos realizados para o Serviço de Geriatria de Referência e de outras especialidades médicas. Resultados: entre os idosos 73,4% eram do sexo feminino; 18,8% tinham 60 a 69 anos, 40,5% entre 70 a 79 e 40,6% contavam 80 anos ou mais. Quanto à escolaridade 63,5% frequentaram apenas o ensino fundamental. A função mais comprometida foi a visão em 72,6% dos casos; a postura em 53,9% dos idosos; a cognição em 52,1%; o humor em 51,9% e a continência urinária em 50,4%. As doenças e condições de saúde mais frequentes identificadas foram hipertensão arterial em 74,5% dos atendidos, distúrbios de visão em 43,1% e depressão em 37,3% da população do estudo. Sobre os encaminhamentos realizados 45,4% foram para o Serviço de Geriatria de Referência. A maior parte dos idosos fazia uso de pelo menos um medicamento (44%). Ressalta-se que há inexistência de uniformidade no preenchimento dos planos de cuidado e uma proporção elevada de dados faltantes para as variáveis. Discussão: os resultados do estudo têm o potencial de contribuir para a melhoria do atendimento aos idosos no Centro Mais Vida, no sentido de identificar as principais enfermidades e agravos. Contudo, ressalta-se a necessidade de melhoria das informações para que possam ser feitas inferências mais robustas sobre os idosos atendidos. Produtos originados desta dissertação: esse trabalho deu origem a dois artigos submetidos a periódicos.Goals: characterizing the clinical and functional profile of elderly sample in the Centre More Life of Hospital das Clínicas of the Federal University of Minas Gerais, in the period between December 2011 to November 2012. Material and methods: this descriptive cross-sectional study, which sample consisted of 894 elderly people. Variables were analysed by sex, age, education and overall functionality, whereas cognition, mood, mobility and communication. There was also an analysis of the most common diseases and health conditions, the number of medications used and referrals made to the service of Geriatrics of Reference and other medical specialties. Results: among the elderly, 73.4% were female; 18.8% were 60 to 69 years old, 40.5% were between 70 to 79 and 40.6% were 80 years or older. Regarding schooling, 63.5% attended only elementary school. The function more compromised was the vision in 72.65 of the cases; posture with 53.9% of incidence; cognition in 52.1% of the cases; the mood at 51.9% and continence in 50.4%. Diseases and health conditions most frequently identified were hypertension in 74.5% of the attendances, vision disorders in 43.1% and depression in 37.3% of the population of the study. About the referrals made, 45.4% were for the service of Geriatrics of reference. Most of the elderly made use of at least one medicine (44%). It should be noted that there is a lack of uniformity in the completion of plans of healthcare and a high proportion of missing data for the variables. Discussion: the results of the study have the potential to contribute to the improvement of care for the elderly in More Life Centre, in order to identify the main illnesses and diseases. However, emphasized the need for improved information so that more robust inferences can be made about the elderly. Products originated by this dissertation: this work has resulted in two papers submitted to journals

Infective Endocarditis in Patients on Chronic Hemodialysis

International audienceInfective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD)

Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.

BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were obtained from the International Collaboration on Endocarditis-Prospective Cohort Study of 4794 patients with definite IE who were admitted to 64 centers from June 2000 through December 2006. Multivariate logistic regression and Cox regression analyses were performed to estimate the impact of early surgery on hospital and 1-year mortality after adjustments for other significant covariates. RESULTS: Of the 857 patients with IE complicated by ischemic stroke syndromes, 198 who underwent valve replacement surgery poststroke were available for analysis. Overall, 58 (29.3%) patients underwent early surgical treatment vs 140 (70.7%) patients who underwent late surgical treatment. After adjustment for other risk factors, early surgery was not significantly associated with increased in-hospital mortality rates (odds ratio, 2.308; 95% confidence interval [CI], .942-5.652). Overall, probability of death after 1-year follow-up did not differ between 2 treatment groups (27.1% in early surgery and 19.2% in late surgery group, P = .328; adjusted hazard ratio, 1.138; 95% CI, .802-1.650). CONCLUSIONS: There is no apparent survival benefit in delaying surgery when indicated in IE patients after ischemic stroke. Further observational analyses that include detailed pre- and postoperative clinical neurologic findings and advanced imaging data (eg, ischemic stroke size), may allow for more refined recommendations on the optimal timing of valvular surgery in patients with IE and recent stroke syndromes

Impact of early valve surgery on outcome of staphylococcus aureus prosthetic valve infective endocarditis: Analysis in the international collaboration of endocarditis-prospective cohort study

Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis-Prospective Cohort Study. Methods. Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results. EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non-S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39-1.15]; P = .15). Conclusions. In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE