Análisis modal de fallos y efectos en las prescripciones farmacológicas informatizadas

  1. J.A. Paredes-Atenciano 1
  2. J.P. Roldán-Aviña 2
  3. Mercedes González-García 3
  4. M.C. Blanco-Sánchez 1
  5. M.A. Pinto-Melero 4
  6. C. Pérez-Ramírez 5
  7. Miguel Calvo Rubio-Burgos 6
  8. F.J. Osuna-Navarro 7
  9. A.M. Jurado-Carmona 7
  1. 1 Dep. Hospitalización Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  2. 2 Cirugía General Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  3. 3 Farmacia Hospitalaria, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  4. 4 Departamento de Enfermería Bloque Quirúrgico, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  5. 5 Servicio de Anestesiología, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  6. 6 Ginecología, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir), Écija, Sevilla, España
  7. 7 Servicio Urgencias, Hospital de Alta Resolución de Écija (Agencia Sanitaria Bajo Guadalquivir) , Écija, Sevilla, España
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Journal:
Revista de calidad asistencial

ISSN: 1134-282X

Year of publication: 2015

Volume: 30

Issue: 4

Pages: 182-194

Type: Article

DOI: 10.1016/J.CALI.2014.12.011 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista de calidad asistencial

Abstract

Objective To identify and analyze errors in drug prescriptions of patients treated in a «high resolution» hospital by applying a Failure mode and effects analysis (FMEA).Material and methods A multidisciplinary group of medical specialties and nursing analyzed medical records where drug prescriptions were held in free text format. An FMEA was developed in which the risk priority index (RPI) was obtained from a cross-sectional observational study using an audit of the medical records, carried out in 2 phases: 1) Pre-intervention testing, and (2) evaluation of improvement actions after the first analysis. An audit sample size of 679 medical records from a total of 2,096 patients was calculated using stratified sampling and random selection of clinical events. Results Prescription errors decreased by 22.2% in the second phase. FMEA showed a greater RPI in «unspecified route of administration» and «dosage unspecified», with no significant decreases observed in the second phase, although it did detect, «incorrect dosing time», «contraindication due to drug allergy», «wrong patient» or «duplicate prescription», which resulted in the improvement of prescriptions. Conclusions Drug prescription errors have been identified and analyzed by FMEA methodology, improving the clinical safety of these prescriptions. This tool allows updates of electronic prescribing to be monitored. To avoid such errors would require the mandatory completion of all sections of a prescription.

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