Processo de dispensação e de administração de medicamento de uso próprio do paciente no hospital: avaliação e melhoria

Abstract

Introduction: Medication errors can lead to harm and global and national actions have been studied to prevent them and thus to promote the strengthening of patient safety barriers. From this perspective, there is a need to discuss patient’s own drug, which is taken from home to the hospital and which, for various reasons, may not be available at the institution. Thus, developing quality management activities is essential for better results in health care for patients who use their own medication in hospital services. Objective: To evaluate the process of dispensing and administering patients' own medication in a secondary hospital in the state of Ceará. Methodology: This is a quasi-experimental before-and-after study with no control group and a quantitative approach, with data collection in November 2023, January and March 2024. The data collection was carried out weekly using an instrument developed for this purpose, and the data sources were patient medical records, the service spreadsheet with records of patients' own medications, and the quantity of each medication in use. Between each data collection, multifaceted interventions were implemented to improve the service. Seven criteria were considered to assess the quality of the process of using patients' own medications in two storage locations: the pharmacy and bedside. The project was approved by the research ethics committee of the Instituto de Saúde e Gestão Hospitalar. Results: In the initial assessment, variations in compliance levels for the criteria were observed in both storage locations. During the reassessment, conducted 90 days after the first interventions, absolute improvement was noted across all criteria, regardless of the storage location. This improvement was significant for three criteria in the bedside storage scenario (C3 – proper scheduling, C4 – correct administration, and C6 – proper storage and identification). Interventions addressed the work processes of professionals, recording systems, and educational actions. Conclusion: The study demonstrated that multifaceted activities promote quality improvement in the use of patients' own medications within the institution, achieving its objectives and emphasizing the importance of continuity and refinement to attain increasingly significant results.