Problemas na comunicação: uma possível causa de erros de medicação

Resumo

OBJECTIVE: This descriptive study identified and analyzed weak points in the communication process during the prescription, dispensing, and administration of medication in a medical unit and pharmacy of a university hospital. METHODS: The data were collected by direct observations during a period of 21 days, review of 294 prescriptions, and interview of 40 health care professionals. RESULTS: Some prescriptions were incomplete, common use of abbreviations, and health care providers were often interrupted or distracted during prescription. During the dispensing phase, many requisition forms were incomplete or filled out wrongly. And, during the administration of medication, there were errors on transcribed labels for the preparation of medication as well as a lack of proper communication between nurses and patients. CONCLUSION: Communication process in place must be revised to guarantee a quality hospital medication system that provides safe patient care.
OBJETIVO: En este estudio descriptivo se identificó y analizó los puntos frágiles de la comunicación durante la realización de la prescripción, dispensación y administración de medicamentos en la unidad de clínica médica y farmacia de un hospital universitario. MÉTODOS: Los datos fueron recolectados a través de observaciones directas durante 21 días; revisiones de 294 prescripciones de medicamentos y 40 entrevistas con profesionales. RESULTADOS: El análisis permitió la identificación de prescripciones incompletas, con abreviaturas, y realizadas bajo interrupciones y distracciones. En la dispensación, las requisiciones presentaron fallas en el llenado de los formularios; en la administración de medicamentos los problemas se referían al uso de etiquetas transcritas para la preparación de la medicación y falta de comunicación entre enfermería y paciente. CONCLUSIONES: Los medios de comunicación utilizados deben ser revisados, a fin de que se cree un sistema de medicación seguro para el paciente.

Descrição

Palavras-chave

Enfermagem, Ansiedade, Morte, Atitude frente a morte, Educação em enfermagem, Medication errors, Medication systems hospital, Communication, Nursing, Hospitalization, Risk management, Errores de medicación, Sistemas de medicación en el hospital, Comunicación, Enfermería, Hospitalización, Control de riesgo

Citação

SILVA, Ana Elisa Bauer Camargo; CASSIANI, Silvia Helena de Bortoli; MIASSO, Adriana Inocenti; OPTIZ, Simone Perufo. Problemas na comunicação: uma possível causa de erros de medicação. Acta Paulista de Enfermagem, São Paulo, v. 20, n. 3, p. 272-276, 2007.