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EASE OF ACCESS TO INTRAVENOUS DRUG COMPATIBILITY INFORMATION FOR CLINICAL PRACTITIONERS

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European Statement

Patient Safety and Quality Assurance

Author(s)

K. Teimori, H. Colldén, R. Asadian Falahieh

Why was it done?

Therapy at an intensive care unit (ICU) involves co-infusion of multiple drugs into the same IV line. This may involve mixing of incompatible drugs resulting in particulates being infused, putting the patient at risk. In 2012, a local survey showed 65% (n=142) of participating nurses had co-administered drugs where they were unsure of their compatibility. Preventing incompatibilities by providing healthcare practitioners with point of care IV drug compatibility information fitted to local needs was deemed a necessity. Drug compatibility requires a thorough understanding of chemistry, and information from published studies must be evaluated and assessed to determine applicability to local clinical conditions. Clinics had requested the support of pharmacists for this work.

What was done?

An online intravenous (IV) compatibility database based on these data was created. A group of international clinical pharmacists interested in collaborating in improving the quality of the database was identified. Information material aimed at educating healthcare personal was developed.

How was it done?

Published drug compatibility data and information on physiochemical properties were collected and assessed by a team of hospital pharmacists for applicability to seven clinics. Support, guidance and expertise in the subject had been readily offered to clinical practitioners through telephone calls, email and meetings.

What has been achieved?

Six custom compatibility charts totaling 3600 drug pairs have been created, and procedure documents for IV compatibility have been implemented in each clinic. Over 30 educational lectures on IV compatibility have been held.

The database consisting of 2500 drug combinations presents accessible detailed information on compatibility. Its quality is continuously reviewed by international colleagues.

What next?

The database is fitted to national clinical traditions, providing accessible data to nurses and physicians to support decisions on which drugs to co-infuse. In the next few years, the database will become nationally available. If integrated into the electronic journal system, this could help doctors consider compatibility issues while prescribing, further improving patient safety.

National monitor for the quality of medication surveillance

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European Statement

Patient Safety and Quality Assurance

Why was it done?

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What was done?

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How was it done?

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What has been achieved?

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What next?

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Medication Safety Audits developed and conducted by a hospital pharmacy in Finland

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Author(s)

E. Celikkayalar, E. Suvikas-Peltonen, J. Palmgren

HIGHLY ACTIVE ANTIRETROVIRAL THERAPY PRESCRIPTIONS IN NAIVE PATIENTS: IMPROVEMENT PLAN

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European Statement

Patient Safety and Quality Assurance

Author(s)

A. Rodríguez-Perez, M.I. Sierra-Torres, M.D. Toscano-Guzmán, A. Monzón-Moreno, M. Soriano-Martinez, A. Lluch-Colomer, M.D. Santos-Rubio

Why was it done?

According to the guidelines and recommendations for the rational use of medication, prescriptions of HAARTs must be standardised following the principles of efficiency and based on the best evidence available.

What was done?

A multidisciplinary group of clinical pharmacists and physicians made an easy-to-read handout that summarised the main recommendations of GESIDA for the treatment of naive patients, treated with highly active antiretroviral therapy (HAART). The hand-out consisted of a table with the allowed and not-allowed antiretroviral combinations and the exceptions. The multidisciplinary group disseminated the handout to the prescribers through clinical sessions. The multidisciplinary group made a 6 month study to evaluate the adherence to GESIDA, previous and after the implementation of the easy-to-read handout.

How was it done?

We did not have any problem implementing these recommendations or organizing the clinical sessions.

What has been achieved?

The multidisciplinary group made a retrospective study of the 6-months previous the implementation of the handout, by a chart review of the prescriptions. One hundred naive patients were evaluated. We found an eleven per cent of deviations of the recommendations, none of them justified. The multidisciplinary group made a prospective study during a 6-months period after the implementation of the handout, by a chart review of the prescriptions. Seventy-one naive patients were evaluated. We found a 7% of deviations of the recommendations, three of them were justified because of co-morbidity that contraindicated the recommended medication. We also made a follow-up of the treatment of the patients of the retrospective study, six of the eleven patients of that group changed their HAART to the recommended ones.

What next?

The multidisciplinary team has periodic meetings to evaluate the adherence to the recommendations and to study news reported by GESIDA. The economic impact of the practice is planned to be evaluated.

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Join us in Prague for the 2nd edition of BOOST!

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BOOST is where visionaries, innovators, and healthcare leaders come together to tackle one of the biggest challenges in hospital pharmacy—medicine shortages.