Ferramentas de gestão da qualidade aplicadas à dispensação/distribuição de medicamentos em farmácia hospitalar: uma revisão de escopo.

Abstract

The process of drug dispensing in hospital pharmacies (HP) is one of the essential steps in health care, but presents high complexity due to the diversity of professionals and clinical conditions of patients. Therefore, the use of quality management tools may be an important strategy to improve the patient safety and to achieve institutional goals, including user satisfaction and reduction of cost.This scoping review sought to identify and describe quality management tools applied to drug dispensing in HP, the quality indicators used and the results obtained. Was developed according to the Cochrane methodology and the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA), being registered at the public platform Open Science Framework (https://doi.org/10.17605/OSF.IO/KP3AJ). The searches were performed in electronic databases Medline (via PubMed), Cochrane Library, Embase, CINAHL and Lilacs, with no limit of date or language. Studies on quality management tools applied to drug dispensing in HP were assessed for eligibility, with extraction and compilation of results developed in a narrative form. From the 1,318 studies identified in the initial search, 11 were included in the review. The quality management tools more frequently reported were: tools related to the definition of root cause (n=4; 36%), e.g. DMAIC (Define, Measure, Analyze, Improve and Control); the cause and effect diagram; FMEA (Failure Mode and Effect Analysis) and its variations (n=4; 36%); and tools related to the LEAN Six Sigma principles (n=3; 27%). The quality indicators used to monitor the results were, mainly, work team satisfaction, time spent performing activities and reduction of errors and costs. The use of quality management tools showed a tendency to improve the indicators of the drug dispensing process in the HP.