Diagnóstico de boas práticas de segurança do paciente relacionadas à gestão da medicação em dois hospitais públicos de Minas Gerais

Abstract

Introduction: Patient safety should be a priority in health institutions, with emphasis on the medication process, which is the focus of the latest global challenge of the World Health Organization in view of alarming and increasing data on medication safety. In this sense, the ISEP-Brazil project stands out with the objective to develop and validate indicators for patient safety practices in the Brazilian context. Considering this scenario, this study aims to describe and analyze the compliance with the ISEP-Brazil patient safety good practice indicators related to medication management in two public hospitals in Minas Gerais. It also aims to evaluate the applicability and limitations of these indicators in these hospitals. Methods: This is a crosssectional study conducted in two large hospitals of the same public hospital network. Hospital 1 (H1) located in the countryside of Minas Gerais and hospital 2 (H2) in the state capitol. The Group 5 indicators (medication management) were collected in February 2018, according to the methodology described in the ISEP-Brazil Project. In addition, through an on-site visit, additional information on the safety profile was carried out in both hospitals. The difference between the proportions of the items served at H1 and H2 was evaluated using the Pearson chi-square test at a level of statistical significance of 5%. Results: both hospitals satisfied satisfactorily more than 65% of the evaluated items (H1 = 71.2%, H2 = 66.7%), with H1 fulfilling three additional items (n = 42) than H2 (n = 39). There was no statistically significant difference between the proportions of items in compliance at H1 and H2 (p = 0.69). However, through additional collection, activities that were not evaluated by the ISEP-Brazil indicators which may contribute to patient safety were detected, especially in H1. Examples of those are: clinical activities, computerization of the dispensing and emergency carts, daily check of dispensing errors. Conclusion: a considerable proportion of subitems was in compliance with the ISEP-Brazil indicators in hospitals. Although there was no statistically significant difference between these proportions, the additional on-site diagnosis allowed identification of a safer medication system in H1.