Desempenho dos profissionais na administração de medicamentos na pediatria: um estudo observacional transversal

Sandoval, Lilia Jannet Saldarriaga; Lima, Francisca Elisângela Teixeira; Barbosa, Lorena Pinheiro; Pascoal, Lívia Maia; Almeida, Paulo César de; Morán, Yesenia Luna

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (3) • 2022 • https://doi.org/10.1590/0034-7167-2020-0299 copiar

Desempenho dos profissionais na administração de medicamentos na pediatria: um estudo observacional transversal

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivos:

avaliar as ações Segurança do Paciente dos profissionais de enfermagem na Administração de Medicamentos na Pediatria

Métodos:

estudo observacional, transversal, quantitativo realizado em 2018, com 25 enfermeiras de um Hospital do Peru. 183 observações foram feitas, utilizou-se o instrumento Segurança do Paciente na administração de medicamentos em Pediatria versão em español. O desempenho dos profissionais foi avaliado pelo Índice de Positividade.

Resultados:

dos 22 itens observados, cinco eram adequados, cinco itens seguros, dois classificados como limítrofes e dez como toleráveis, entre os quais se destacam; Leva para a cama apenas medicamentos prescritos para uma única criança e mantém um registro adequado dos medicamentos preparados que serão armazenados.

Conclusões:

observamos fragilidades no processo de administração de medicamentos, visto que apenas 10 itens foram classificados como seguros ou adequados, reforçando a necessidade de ações de educação permanente por parte da instituição para a formação do enfermeiro.

Descritores:
Segurança do Paciente; Avaliação de Desempenho Profissional; Qualidade da Assistência à Saúde; Pediatria; Enfermagem

Variables	n	%
Sex
Feminine	25	100
Age (years)
27 - 31	11	44.0
32 - 36	8	32.0
37 - 41	6	24.0
Vocational training
Mastered	3	12.0
Doctorate	1	4.0
Specialization	21	84.0
Time of professional experiece (years)
2 - 5	12	48.0
6 - 10	12	48.0
11 - 15	1	4.0
Time of experience in pediatrícs (years)
2 - 4	18	72.0
5 - 6	7	28.0
Weekly hourly load
36	7	28.0
37	10	40.0
48	8	32.0
Work in Pediatric hospitalization
Litle wearing	4	16.0
Very exhausting	21	84.0

Observed actions of drug preparation and administration	N=183	PI^* * PI - Index of Positivity; - = Unobserved actions.
1 - Use at least two identifiers (child's full name, date of birth, or medical record number) to identify the child before administering medication.	158	86.3
2 - Confirm the name of the medicine with the prescription before giving it to the child.	108	59.0
3 - Bring to bed only medications prescribed for a single child	46	25.1
4 - Administer medication by verbal order only in an emergency.	130	71.0
5 - Confirm if the child is not allergic to the prescribed medication, identifying it differently with a bracelet and notice in the medical record, alerting the entire team.	151	82.5
6 - Identify the prescribed route of administration for the drug.	177	96.7
7 - Check if the prescribed route is the recommended technique for administering the medication	180	98.4
8 - Wash your hands before preparing and administering medications.	168	91.8
9 - Uses aseptic materials and techniques to administer medications according to the different routes of administration.	116	63.3
10 - Prepare the medicine immediately before administration.	148	80.9
11 - Administer the medication at the correct time.	179	97.8
12 - Adjust the medication administration schedules to the routine already established before your hospitalization.	152	83.1
13 - Please carefully confirm the dosage according to the medical prescription for the drug	108	59.0
14 - Confirm drip rate, programming and operation of continuous infusion pumps with medical prescription.	130	71.0
15 - Double check by two professionals of the dilution calculations and administration of potentially dangerous drugs or high surveillance drugs.	13	7.1
16 - Uses standard measuring instruments in the preparation of medications to measure the exact dose (ex: millimeter syringes, dosing cups).	79	43.2
17 - Return any unadministered leftovers to the pharmacy.	-	-
18 - Record in the Kardex the schedule of administration and in the medical history occurrences of the drug immediately after administering each dose.	179	97.8
19 - Report incidents, adverse reactions and adverse events to the Quality Management office in the Registration and Report Card.	-	-
20 - Maintains an adequate record of prepared drugs that will be stored (with date and time of handling, drug concentration, name of the person responsible for preparation and validity).	35	19.1
21 - Monitors the temperature of the medicine-conditioning refrigerator by recording the values daily.	-	-
22 - Clarifies doubts about ineligibility of the prescription, indication of the drug and dosage before administering the drug.	73	39.9
23 - Guides the child and the companion on the medication administered and the justification, the indication, the frequency with which it will be administered and the expected effects.	23	12.6
24 - Verifies if the medicine to be administered has a pharmaceutical presentation compatible with the route of administration of the medical prescription.	152	83.1
25 - Evaluate the child to identify, when possible, if the medication had the desired effect.	-	-
26 - Inform the doctor who prescribed all the different effects than expected (in intensity and form) for the drug.	55	30.1

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Lilia Jannet Saldarriaga Sandoval, E-mail: liyasa45@hotmail.com