Implementation of bedside medication preparation in intensive care: post-improvement cycle.

Q3 Nursing Revista gaucha de enfermagem / EENFUFRGS Pub Date : 2024-10-07 eCollection Date: 2024-01-01 DOI:10.1590/1983-1447.2024.20230288.en
Ruy de Almeida Barcellos, Cindy Klagenberg Silva, Wiliam Wegner, Karina de Oliveira Azzolin, Luísa Brehm Santana, Mirella Zolner Dos Santos
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引用次数: 0

Abstract

Objective: To assess the implementation of the bedside medication preparation process in an Intensive Care Unit, following a quality improvement cycle.

Method: A quasi-experimental study with non-paired samples, pre- and post-implementation, conducted in an Intensive Care Unit of a public hospital in southern Brazil, from September 2022 to April 2023, following the guidelines of the Standards for Quality Improvement Reporting Excellence 2.0. Adherence to bedside medication preparation, interruptions during preparation, adequate storage, identification and validity of multidose medications, and recording of storage refrigerator temperature were evaluated. Shapiro-Wilk and Mann-Whitney U tests were used for data analysis, and Carter's Positivity Index was used to determine compliance with observed practices.

Results: Forty-five audits were conducted pre-intervention and 122 audits three months after the implementation of the improvement cycle. All variables showed significant improvements. Overall compliance increased from 46% to 80% in the pre- and post-implementation periods, respectively, indicating a transition from "undesirable" to "safe" care stratum.

Conclusion: The study revealed a positive relationship between the implementation of a quality improvement cycle focused on medication preparation and improvements in patient safety.

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在重症监护中实施床旁备药:改进后周期。
摘要评估重症监护病房按照质量改进周期实施床旁药物准备流程的情况:根据卓越质量改进报告标准 2.0 的指导原则,于 2022 年 9 月至 2023 年 4 月在巴西南部一家公立医院的重症监护病房开展了一项实施前和实施后的非配对样本准实验研究。对床边药物准备的依从性、准备过程中的中断、充分的储存、多剂量药物的识别和有效性以及储存冰箱温度的记录进行了评估。数据分析采用 Shapiro-Wilk 检验和 Mann-Whitney U 检验,并使用卡特积极性指数来确定观察到的做法是否合规:结果:干预前进行了 45 次审核,改进周期实施三个月后进行了 122 次审核。所有变量均有明显改善。在实施前和实施后,总体合规率分别从 46% 提高到 80%,表明护理层从 "不理想 "过渡到了 "安全":研究表明,实施以药物准备为重点的质量改进周期与改善患者安全之间存在积极关系。
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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
118
审稿时长
16 weeks
期刊介绍: A Escola de Enfermagem da Universidade Federal do Rio Grande do Sul edita e publica a Revista Gaúcha de Enfermagem para divulgar a produção científica da Enfermagem e áreas afins. Foi criada em 1976 e atualmente tem periodicidade trimestral.
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