Universidade Federal do Rio Grande do Sul (UFRGS). Escola de Enfermagem e de Saúde Coletiva. Porto Alegre, Rio Grande do Sul, Brasil.
Hospital de Clínicas de Porto Alegre (HCPA). Porto Alegre, Rio Grande do Sul, Brasil.
Rev Gaucha Enferm. 2024 Oct 7;45(Spe 1):e20230288. doi: 10.1590/1983-1447.2024.20230288.en. eCollection 2024.
To assess the implementation of the bedside medication preparation process in an Intensive Care Unit, following a quality improvement cycle.
A quasi-experimental study with non-paired samples, pre- and post-implementation, conducted in an Intensive Care Unit of a public hospital in southern Brazil, from September 2022 to April 2023, following the guidelines of the Standards for Quality Improvement Reporting Excellence 2.0. Adherence to bedside medication preparation, interruptions during preparation, adequate storage, identification and validity of multidose medications, and recording of storage refrigerator temperature were evaluated. Shapiro-Wilk and Mann-Whitney U tests were used for data analysis, and Carter's Positivity Index was used to determine compliance with observed practices.
Forty-five audits were conducted pre-intervention and 122 audits three months after the implementation of the improvement cycle. All variables showed significant improvements. Overall compliance increased from 46% to 80% in the pre- and post-implementation periods, respectively, indicating a transition from "undesirable" to "safe" care stratum.
The study revealed a positive relationship between the implementation of a quality improvement cycle focused on medication preparation and improvements in patient safety.
在一个重症监护病房(ICU)中,通过质量改进周期,评估床边用药准备流程的实施情况。
这是一项在巴西南部一家公立医院的 ICU 中进行的准实验研究,采用非配对样本,在 2022 年 9 月至 2023 年 4 月期间进行了实施前和实施后的评估,遵循了《质量改进报告卓越标准 2.0》的指南。评估了床边用药准备的遵守情况、准备过程中的中断情况、适当的储存、多剂量药物的标识和有效期以及储存冰箱温度的记录。使用 Shapiro-Wilk 和 Mann-Whitney U 检验进行数据分析,并用 Carter 的阳性指数来确定对观察到的实践的遵守情况。
在干预前进行了 45 次审核,在实施改进周期三个月后进行了 122 次审核。所有变量都显示出显著的改善。总体合规性从实施前的 46%提高到实施后的 80%,表明从“不良”护理层过渡到“安全”护理层。
研究表明,专注于用药准备的质量改进周期的实施与患者安全的改善之间存在积极的关系。