Seguridad del paciente en la administración de antibióticos: evaluación del riesgo

M. Maqueda Palau, E. Pérez Juan
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引用次数: 2

Abstract

Objective

To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix.

Material and method

A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected. In this period, 257 patients received antimicrobial treatment and 26 antibiotics were evaluated. Variables studied: A risk assessment of each antibiotic using the scale Risk Assessment Tool, of the National Patient Safety Agency, as well as pH, osmolarity, type of catheter recommended for administration, and compatibility and incompatibility with other antibiotics studied.

Results

Almost two-thirds (65.3%) of antibiotics had more than 3 risk factors (represented by a yellow stripe), with the remaining 34.7% of antibiotics having between 0 and 2 risk factors (represented by a green stripe). There were no antibiotics with 6 or more risk factors (represented by a red stripe). Most drugs needed reconstitution, additional dilution, and the use of part of the vial to administer the prescribed dose.

Conclusion

More than half of the antibiotics studied had a moderate risk level; thus measures should be adopted in order to reduce it. The risk matrix is a useful tool for the assessment and detection of weaknesses associated with the preparation and administration of intravenous antibiotics.

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抗生素使用中的患者安全:风险评估
目的采用风险矩阵法确定重症监护病房常用抗生素制备和给药的风险水平。材料和方法本研究采用情况分析和文献综述的方法,对静脉注射治疗、药物及其给药途径的数据库、方案和良好实践指南进行分析。选取2015年4月1日至6月30日在ENVIN-HELICS项目中登记的ICU使用最多的抗生素。在此期间,257名患者接受了抗菌药物治疗,并对26种抗生素进行了评估。研究的变量:使用国家患者安全机构的风险评估工具量表对每种抗生素进行风险评估,以及pH值、渗透压、推荐给药的导管类型以及与其他抗生素的相容性和不相容性。结果65.3%(三分之二)的抗生素存在3种以上危险因素(以黄色条纹表示),34.7%的抗生素存在0 ~ 2种危险因素(以绿色条纹表示)。没有抗生素具有6个或6个以上的危险因素(用红色条表示)。大多数药物需要重新配制,进一步稀释,并使用部分小瓶来给药。结论半数以上的抗生素具有中等危险水平;因此,应该采取措施来减少它。风险矩阵是评估和检测与静脉注射抗生素的制备和给药相关的弱点的有用工具。
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