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Efecto de intervenciones farmacéuticas en la ocurrencia de errores de medicación en el servicio de cardiología de un hospital universitario
(Universidad de Chile, 2016)
. Sin embargo, es necesario realizar estudios multicéntricos, con diseños de investigación más robustos que permitan evaluar la efectividad del PIF, en centros de atención de salud similares...
Background: Medication errors (ME) are the main limiting factors on the effectiveness and safety of drug therapy, especially in clinical services where elderly patients often take multiple prescription medications, like Cardiology Services. However, there is limited information about ME occurrences and its characteristics in this type of patients and the effect of the strategies created to reduce ME. Objective: To estimate the effect of a pharmaceutical intervention program (PIP) on the frequency of medication errors in a Cardiology Service. Methodology: A Quasi-experimental study comparing before and after, for which a random sample of hospitalized patients from the Cardiology Service unit of a university hospital were selected. The study design considered three phases, the first –diagnostic stage - and third - post intervention stage - observational stages, during which the frequency of ME was measured, characterized and identified the stages most susceptible to errors. During the second phase a multidisciplinary team implemented a PIP program to prevent and / or reduce Medication errors (ME). ME detection was made through direct and sequential observation of all stages of the Medication Usage System (MUS), comparing each stage with the indication of the clinical records. The differences found were recorded as ME, then they were categorized by type and subtype, and they were also classified according to severity. The definition of ME used in this paper came from the National Coordinating Council for Medication Error Reporting and Prevention. PIP interventions were jointly selected by a multidisciplinary team considering the results obtained during the diagnostics phase and criteria such as economical, possibility to implement in a general manner without the use of technology and ease of implementation in the short term, such as staff training on safe preparation and administration of medications and standardization of procedures: schedule for making and dispensing prescriptions and activities related with the preparation and administration of medications, and adding a system to voluntary report ME. The indicator of the effect of the intervention was the frequency of medication with at least 1 ME, determined as the ratio between the number of medicines with at least one ME and the total number of medications evaluated. Data were analyzed using the statistical software STATA 11.0, using descriptive statistics that shows frequencies and percentages for qualitative variables and means and standard deviation for quantitative variables. Comparative analyzes were made through the x2 test. Results: A total of 434 medication and 71 patients were evaluated, 167 (38.5%) medications in 37 (52.1%) patients in the diagnosis phase, and 267 (61.5%) medications in 34 (47.9%) patients in the post-intervention phase. 71.8% of the sample patients were men, with an average age of 64.2 ± 12.4 years, with a Charlson Comorbidity Index of 4.6 ± 2.3 points. The implementation of the PIP included 13 different strategies out of the 18 proposed, which helped reduce the overall frequency of medications with at least one ME by 29.1% (49.1% to 34.8%; p<0.01).The largest variations in the frequency of ME were recorded during the dispensing stage, with a change of 66.7% (10.2% to 3.4%; p<0.004) and during the administrating stage, with a change of 38.8% (26.3% to 16.1%; p<0.01). The chance of ME was significantly reduced on Wednesdays and Fridays, with the administration of oral medications and with the drugs supplied by the hospital and the patient. The therapeutic group most likely to ME was analgesics / anti-inflammatories. The implementation of a non-technological PIP by a multidisciplinary team, managed to reduce by approximately a third the frequency of ME in the Cardiology Service. Nevertheless, it is needed to conduct multicenter studies with more robust research designs that will allow evaluating the effectiveness of PIP in similar care health centers...
Background: Medication errors (ME) are the main limiting factors on the effectiveness and safety of drug therapy, especially in clinical services where elderly patients often take multiple prescription medications, like Cardiology Services. However, there is limited information about ME occurrences and its characteristics in this type of patients and the effect of the strategies created to reduce ME. Objective: To estimate the effect of a pharmaceutical intervention program (PIP) on the frequency of medication errors in a Cardiology Service. Methodology: A Quasi-experimental study comparing before and after, for which a random sample of hospitalized patients from the Cardiology Service unit of a university hospital were selected. The study design considered three phases, the first –diagnostic stage - and third - post intervention stage - observational stages, during which the frequency of ME was measured, characterized and identified the stages most susceptible to errors. During the second phase a multidisciplinary team implemented a PIP program to prevent and / or reduce Medication errors (ME). ME detection was made through direct and sequential observation of all stages of the Medication Usage System (MUS), comparing each stage with the indication of the clinical records. The differences found were recorded as ME, then they were categorized by type and subtype, and they were also classified according to severity. The definition of ME used in this paper came from the National Coordinating Council for Medication Error Reporting and Prevention. PIP interventions were jointly selected by a multidisciplinary team considering the results obtained during the diagnostics phase and criteria such as economical, possibility to implement in a general manner without the use of technology and ease of implementation in the short term, such as staff training on safe preparation and administration of medications and standardization of procedures: schedule for making and dispensing prescriptions and activities related with the preparation and administration of medications, and adding a system to voluntary report ME. The indicator of the effect of the intervention was the frequency of medication with at least 1 ME, determined as the ratio between the number of medicines with at least one ME and the total number of medications evaluated. Data were analyzed using the statistical software STATA 11.0, using descriptive statistics that shows frequencies and percentages for qualitative variables and means and standard deviation for quantitative variables. Comparative analyzes were made through the x2 test. Results: A total of 434 medication and 71 patients were evaluated, 167 (38.5%) medications in 37 (52.1%) patients in the diagnosis phase, and 267 (61.5%) medications in 34 (47.9%) patients in the post-intervention phase. 71.8% of the sample patients were men, with an average age of 64.2 ± 12.4 years, with a Charlson Comorbidity Index of 4.6 ± 2.3 points. The implementation of the PIP included 13 different strategies out of the 18 proposed, which helped reduce the overall frequency of medications with at least one ME by 29.1% (49.1% to 34.8%; p<0.01).The largest variations in the frequency of ME were recorded during the dispensing stage, with a change of 66.7% (10.2% to 3.4%; p<0.004) and during the administrating stage, with a change of 38.8% (26.3% to 16.1%; p<0.01). The chance of ME was significantly reduced on Wednesdays and Fridays, with the administration of oral medications and with the drugs supplied by the hospital and the patient. The therapeutic group most likely to ME was analgesics / anti-inflammatories. The implementation of a non-technological PIP by a multidisciplinary team, managed to reduce by approximately a third the frequency of ME in the Cardiology Service. Nevertheless, it is needed to conduct multicenter studies with more robust research designs that will allow evaluating the effectiveness of PIP in similar care health centers...
Mejora en los procesos de planificación, control y monitoreo del Servicio de Urgencia del Hospital Clínico de la Universidad de Chile
(Universidad de Chile, 2015)
(saturación o colapso), lo que genera largas esperas por atención, insatisfacción de los pacientes, merma en el prestigio y funcionamiento institucional, y por sobre todo, riesgos para la salud de los pacientes. El Servicio de Urgencia del Hospital Clínico de...
Plan de negocio para la creación de cadena Centros de Atención Primaria Oftalmológica
(Universidad de Chile, 2018)
calidad técnica en atenciones de especialidad, considerando los
aspectos preventivos, promocionales, asistenciales, curativos, y de control
epidemiológico, con un enfoque de salud familiar integral.
Este plan de negocios, busca demostrar la viabilidad...
. La Organización se dedicará a otorgar prestaciones de atención oftalmológica primaria ambulatorias, directamente en los centros. Brindando a cada paciente un ambiente de seguridad y calidad acorde a lo que indica la normativa de Servicio Regional...
. La Organización se dedicará a otorgar prestaciones de atención oftalmológica primaria ambulatorias, directamente en los centros. Brindando a cada paciente un ambiente de seguridad y calidad acorde a lo que indica la normativa de Servicio Regional...
Centro de diálisis Dialimed
(Universidad de Chile, 2015-03)
para usuarios adultos, con una atención personalizada de primera calidad. El proyecto considera atención integral al usuario y su relación con su entorno familiar, a través de prestaciones adicionales especializadas como, nutricionista, psicólogo...
“Garden Dreams"
(Universidad de Chile, 2021-06)
de 65 años, que
buscan tener una mejor calidad de vida, localizados en la comuna de Concepción
(primera etapa) y Temuco (segunda etapa).
Corporativos: instituciones públicas como municipalidades que poseen dentro de sus
programas atención o...
equipamiento de última generación acompañadas de profesionales competentes con conocimientos tanto en su área de trabajo como en la atención al cliente. Calidad, para Garden Dreams, también se asocia 18 en utilizar productos de calidad en la recreación...
equipamiento de última generación acompañadas de profesionales competentes con conocimientos tanto en su área de trabajo como en la atención al cliente. Calidad, para Garden Dreams, también se asocia 18 en utilizar productos de calidad en la recreación...
Elaboración de índice de calidad de la atención médica para evaluar inversiones de CESFAM y propuesta de mejoras metodológicas
(Universidad de Chile, 2019)
elaboró el Índice de Calidad de la Atención Médica a través de la metodología Proceso de Análisis Jerárquico (AHP), basándose en el criterio de los seis expertos mencionados. Como resultado, se obtuvo un índice compuesto de cinco criterios estratégicos que...
Estudio de cambio de metodología de atención de urgencia en Hospital Exequiel González Cortés
(2018)
cambio de metodología de atención de paciente móvil a paciente fijo, con el fin de mejorar la calidad de la atención dentro del contexto del modelo integral en salud, basado en la familia y la comunidad y los derechos de los pacientes y sus familias...
Plan de negocio para una cadena de Centros Oftalmológicos
(Universidad de Chile, 2019)
El objetivo de este trabajo fue elaborar un Plan de Negocio para el establecimiento de una cadena de centros oftalmológicos con un modelo de negocios eficiente, rentable, sostenible y escalable que ofrezca un servicio con la mayor calidad...
Factores de éxito para la acreditación de la calidad en salud: el caso del Hospital Exequiel González Cortés
(Universidad de Chile, 2014)
El presente estudio de caso busca identificar cuáles son los elementos de la gestión que favorecen que un hospital público logre la acreditación de la calidad sanitaria en Chile. Tiene un énfasis práctico, ya que recoge la opinión de actores que...
Propuesta de una escala para medir la calidad del servicio de los centros de atención secundaria de salud
(Fundação Getulio Vargas, 2008)
medir de manera óptima la calidad del servicio que los Centros de Atención Secundaria ofrecen a sus pacientes. Para lograr este objetivo, se aplicó una encuesta estructurada y posteriormente se realizó un exhaustivo análisis psicométrico de los datos, a...