scholarly journals FAST HUG: UMA FERRAMENTA PARA FARMÁCIA CLÍNICA NA ATENÇÃO E SEGURANÇA DO PACIENTE CRÍTICO

2018 ◽  
Vol 10 (2) ◽  
pp. 59-64
Author(s):  
Nayara Aparecida Maioli ◽  
Aline Fernanda dos Santos Ferrari ◽  
Tatiane Domingos dos Santos ◽  
Hernani Cesar Barbosa Santos
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Clinical Pharmacist ◽  
Drug Related Problems ◽  
Specific Training ◽  
Effective Care ◽  
Promote Patient Safety

FAST HUG is a check-listcomposed of seven essential items in daily prescription in patients hospitalized inthe Intensive Care Unit (ICU), allowing the identification of drug-related problems in these units, and seeks to ensure a safe, efficient and effective assistance to patients. The purpose of the discussion is to explain the advantages of using FAST HUG by clinical pharmacists in health care and safety of critically ill patients. In the literature review, it was observed that the FAST HUG to identify and prevent medication errors, promote patient safety, avoid problems arising from the care and maximize intensive care, and underline the importance of pharmaceutical care in clinical practice. Using FAST HUG ensures effective care and patient safety. Although there are still difficulties for specific training of intensive care clinical pharmacist, can be seen several clinical pharmacist action opportunities in the ICU.

scholarly journals Clinical pharmacist assessment of drug-related problems among intensive care unit patients in a Turkish university hospital

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Aslınur Albayrak ◽  
Bilgen Başgut ◽  
Gülbin Aygencel Bıkmaz ◽  
Bensu Karahalil
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
University Hospital ◽  
Pharmacy Services ◽  
Drug Related Problems ◽  
Electrolyte Disorders ◽  
Drug Induced ◽  
Clinical Pharmacy Services

Abstract Background Critically ill patients treated in the intensive care units (ICUs) often suffer from side effects and drug-related problems (DRPs) that can be life-threatening. A way to prevent DRPs and improve drug safety and efficacy is to include clinical pharmacists in the clinical team. This study aims to evaluate the classification of drug-related problems and the implementation of clinical pharmacy services by a clinical pharmacist in the ICU of a university hospital in Turkey. Methods This study was carried out prospectively between December 2020 and July 2021 in Gazi University Medical Faculty Hospital Internal Diseases ICU. All patients hospitalized in the intensive care unit for more than 24 h were included in the study. During the study, the clinical pharmacist's interventions and other clinical services for patients were recorded. DRPs were classed according to the Pharmaceutical Care Network Europe V.8.02. Results A total of 151 patients were included during the study period corresponding to 2264 patient-days. Patients with DRPs had a longer hospital stay and a higher mortality rate (p < 0.05). 108 patients had at least one DRP and the total number of DRPs was 206. There was an average of 1.36 DRPs per patient, 71.5% of patients experienced DRP and 89.22 DRPs per 1000 patient-days. A total of 35 ADEs were observed in 32 patients. ADE incidence was per 1000 patient-days 15.45. ADEs were caused by nephrotoxicity (48.57%), electrolyte disorders (17.14%), drug-induced thrombocytopenia (17.14%), liver enzyme increase (8.57%) and other causes (8.57%). Drug selection (40.29%) and dose selection (54.36%) constituted most of the causes of DRPs. Dose change was the highest percentage of planned interventions with a rate of 56.79%. Intervention was accepted at a rate of 90.8% and it was fully implemented. Conclusion In this study, the importance of the clinical pharmacist in the determination and analysis of DRPs was emphasized. Clinical pharmacy services like the one described should be implemented widely to increase patient safety.

scholarly journals Clinical Requirements of Future Patient Monitoring in the Intensive Care Unit: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Akira-Sebastian Poncette ◽  
Claudia Spies ◽  
Lina Mosch ◽  
Monique Schieler ◽  
Steffen Weber-Carstens ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Qualitative Study ◽  
Patient Monitoring ◽  
Digital Health ◽  
Alarm Management ◽  
Novel Technology ◽  
Future Patient

BACKGROUND In the intensive care unit (ICU), continuous patient monitoring is essential to detect critical changes in patients’ health statuses and to guide therapy. The implementation of digital health technologies for patient monitoring may further improve patient safety. However, most monitoring devices today are still based on technologies from the 1970s. OBJECTIVE The aim of this study was to evaluate statements by ICU staff on the current patient monitoring systems and their expectations for future technological developments in order to investigate clinical requirements and barriers to the implementation of future patient monitoring. METHODS This prospective study was conducted at three intensive care units of a German university hospital. Guideline-based interviews with ICU staff—5 physicians, 6 nurses, and 4 respiratory therapists—were recorded, transcribed, and analyzed using the grounded theory approach. RESULTS Evaluating the current monitoring system, ICU staff put high emphasis on usability factors such as intuitiveness and visualization. Trend analysis was rarely used; inadequate alarm management as well as the entanglement of monitoring cables were rated as potential patient safety issues. For a future system, the importance of high usability was again emphasized; wireless, noninvasive, and interoperable monitoring sensors were desired; mobile phones for remote patient monitoring and alarm management optimization were needed; and clinical decision support systems based on artificial intelligence were considered useful. Among perceived barriers to implementation of novel technology were lack of trust, fear of losing clinical skills, fear of increasing workload, and lack of awareness of available digital technologies. CONCLUSIONS This qualitative study on patient monitoring involves core statements from ICU staff. To promote a rapid and sustainable implementation of digital health solutions in the ICU, all health care stakeholders must focus more on user-derived findings. Results on alarm management or mobile devices may be used to prepare ICU staff to use novel technology, to reduce alarm fatigue, to improve medical device usability, and to advance interoperability standards in intensive care medicine. For digital transformation in health care, increasing the trust and awareness of ICU staff in digital health technology may be an essential prerequisite. CLINICALTRIAL ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173 (Archived by WebCite at http://www.webcitation.org/77T1HwOzk)

scholarly journals Developing Patient Safety Standards for Quality Improvement in the NICUs: A Mixed-Methods Protocol

2021 ◽  
Author(s):  
Zahra Shahkolahi ◽  
Alireza Irajpour ◽  
Soheila Jafari-Mianaei ◽  
Mohammad Heidarzadeh
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Mixed Methods ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Safety Standards ◽  
The World

Abstract Background Neonatal intensive care unit is one of the accident-prone environments in the health care system. A range of structural and process factors threaten hospitalized infant safety in this unit. These factors are prevented by identifying safety needs and taking the right actions. In this regard, some countries in the world have developed standards. Developing standards based on current knowledge, available resources, and context that provide care, determine patient injury prevention requirements. Likewise, it can be a source for national development and application of guidelines, protocol, and laws. This study aims to develop patient safety standards in the Neonatal intensive care units of the Islamic Republic of Iran. Methods This mixed methods study will apply the Exploration, Preparation, Implementation, Sustainment framework to develop patient safety standards. The first three phases are the focus of this study. Due to investigating the long-term effects, it doesn't consider Phase 4(Sustainment). In each of these phases, a set of activities takes place. Designing Phase 1 (Exploration) is based on the World health organization model to develop standards. Determining the validity and applicability of developing standards will be done in Phase2 (preparation) and Phase 3 (implementation), respectively. Discussion Patient safety standards from this study are developed based on valid evidence and a comprehensive theoretical view. Additionally, considering parents' roles and the interdisciplinary experts' views in the neonatal intensive care unit. In this regard, determining the minimum requirements to maintain patient safety and developing evidence-based practice will be improved efficiency and effectiveness and contributed to equitable and higher quality health care delivery. The application of developing standards will be improving patient safety and quality of health care in the neonatal intensive care units of Iran.

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

Atmung – Standardisierte Checkliste macht Intubation von Neugeborenen sicherer

2017 ◽  
Vol 22 (03) ◽  
pp. 124-125
Author(s):  
Maria Weiß
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Improve Patient Safety ◽  
Improve Patient

Hatch LD. et al. Intervention To Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics 2016; 138: e20160069 Kinder auf der Neugeborenen-Intensivstation sind besonders durch Komplikationen während des Krankenhausaufenthaltes gefährdet. Dies gilt auch für die Intubation, die relativ häufig mit unerwünschten Ereignissen einhergeht. US-amerikanische Neonatologen haben jetzt untersucht, durch welche Maßnahmen sich die Komplikationsrate bei Intubationen in ihrem Perinatal- Zentrum senken lässt.

Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Application Time ◽  
Improve Hand Hygiene ◽  
Independent Observer ◽  
Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

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