Errores de prescripción de antimicrobianos de reserva en la emergencia de un hospital público Nivel III-1 de Trujillo, 2022-2023
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Date
2024
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Universidad Nacional de Trujillo
Abstract
El siguiente trabajo de investigación tiene por objetivo determinar el tipo, frecuencia y niveles de severidad de los errores de prescripción de antimicrobianos de reserva, dispensados en la farmacia de emergencia de un hospital público de nivel III-I de Trujillo, en el período septiembre 2022 - agosto 2023. Se analizaron 1344 recetas de antimicrobianos de reserva atendidas en el servicio de emergencia y se identificaron 5685 errores de prescripción, éstos fueron clasificados en 4 dimensiones, teniendo en cuenta su relación con: paciente, medicamento, prescriptor y formato de la receta. Se agruparon los errores en cada dimensión, según tipos determinados a partir de las precisiones del manual de buenas prácticas de prescripción vigente en el Perú. La severidad de los errores fue clasificada en 4 niveles: bajo, intermedio, alto y sin error, teniendo en cuenta la cantidad de errores por receta médica. Los datos fueron sujetos a un análisis estadístico ANOVA y Diferencia Mínima Significativa (DMS). El error de prescripción más frecuente fue el relacionado al formato de la receta, la ilegibilidad, con un 19,10 % seguido del error relacionado al medicamento, duración del tratamiento incorrecto, con 14,79 %. Se encontró una mayor frecuencia de errores de prescripción en los tipos relacionados al medicamento en un 38,75 %. Solo en un 6% de las recetas analizadas no se encontraron errores de prescripción, siendo el nivel de severidad más frecuente, el nivel alto (más de 3 errores) en un 59,52 % del total de recetas, seguido del nivel intermedio en un 26,93 %. La tendencia al incremento de la presencia de errores de prescripción de nivel de severidad alto, intermedio, bajo y sin error no fueron significativas (p>0,05); por presentar valores de correlación (R) menores a 0,47. La diferencia de los promedios de recetas con niveles de severidad alto (67 recetas mensuales con más de 3 errores) y de recetas con niveles de severidad intermedio (30 recetas mensuales con 2 errores) fueron altamente significativas (p<0,001). Se concluye que los errores de prescripción de antimicrobianos de reserva en el hospital son muy frecuentes y están relacionados a prácticas que podrán ser mejoradas con políticas de prevención.
ABSTRACT The following research work aims to determine the type, frequency and severity levels of prescription errors of reserve antimicrobials, dispensed in the emergency pharmacy of a level III-I public hospital in Trujillo, in the period September 2022. - August 2023. 1,344 reserve antimicrobial prescriptions treated in the emergency service were analysed and 5,685 prescription errors were identified. These were classified into 4 dimensions, taking into account their relationship with: patient, medication, prescriber and prescription format. Errors were grouped within each dimension, according to types determined from the specifications of the manual of good prescription practices in force in Peru. The severity of the errors were classified into 4 levels: low, intermediate, high and no error, taking into account the number of errors per medical prescription. The data were subjected to ANOVA and Least Significant Difference (LMD) statistical analysis. The most frequent prescription error was related to the format of the prescription, illegibility, with 19.10% followed by the error related to the medication, duration of incorrect treatment, with 14.79%. A higher frequency of prescription errors was found in the types related to the medication at 38.75%. Only in 6% of the recipes analysed were no prescription errors found, with the most frequent level of severity being the high level (more than 3 errors) in 59.52% of the total prescriptions, followed by the intermediate level in a 26.93%. The tendency to increase the presence of prescription errors of high, intermediate, low and no error severity levels was not significant (p>0.05); for presenting correlation values (R) less than 0.47. The difference in the averages of prescriptions with high severity levels (67 monthly prescriptions with more than 3 errors) and of prescriptions with intermediate severity levels (30 monthly prescriptions with 2 errors) were highly significant (p<0.001). It is concluded that errors in prescribing reserve antimicrobials in the hospital are very frequent and are related to practices that can be improved with prevention policies
ABSTRACT The following research work aims to determine the type, frequency and severity levels of prescription errors of reserve antimicrobials, dispensed in the emergency pharmacy of a level III-I public hospital in Trujillo, in the period September 2022. - August 2023. 1,344 reserve antimicrobial prescriptions treated in the emergency service were analysed and 5,685 prescription errors were identified. These were classified into 4 dimensions, taking into account their relationship with: patient, medication, prescriber and prescription format. Errors were grouped within each dimension, according to types determined from the specifications of the manual of good prescription practices in force in Peru. The severity of the errors were classified into 4 levels: low, intermediate, high and no error, taking into account the number of errors per medical prescription. The data were subjected to ANOVA and Least Significant Difference (LMD) statistical analysis. The most frequent prescription error was related to the format of the prescription, illegibility, with 19.10% followed by the error related to the medication, duration of incorrect treatment, with 14.79%. A higher frequency of prescription errors was found in the types related to the medication at 38.75%. Only in 6% of the recipes analysed were no prescription errors found, with the most frequent level of severity being the high level (more than 3 errors) in 59.52% of the total prescriptions, followed by the intermediate level in a 26.93%. The tendency to increase the presence of prescription errors of high, intermediate, low and no error severity levels was not significant (p>0.05); for presenting correlation values (R) less than 0.47. The difference in the averages of prescriptions with high severity levels (67 monthly prescriptions with more than 3 errors) and of prescriptions with intermediate severity levels (30 monthly prescriptions with 2 errors) were highly significant (p<0.001). It is concluded that errors in prescribing reserve antimicrobials in the hospital are very frequent and are related to practices that can be improved with prevention policies
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Keywords
Errores de prescripción