BACKGROUND AND AIM
Drug prescription and administration is a very articulated and complex process, especially in intensive care and carries with it potential risks of drug administration errors. Risk management assessment is required for procurement, storage, distribution, prescription, administration, preparation, recognition and reconciliation of these drugs.
To Conduct a structured analysis of drug administration in intensive care we aimed at identifying any critical issues, currently existing barriers, areas for improvement and organizational strategies to reduce risks and optimize the outcomes in terms of quality and safety
A multidisciplinary team was set up that analyzed the pharmacological process in intensive care using the Patient Safety Walkaround and Project management tool. Procedures were revised and new functions were structured for the shared computerised medication chart (e-STU), adding information content tosupport clinical decisions. Warning and alerts using icons have been introduced to draw attention to medical and nursing staff when prescribing and administering drugs with a particular level of risk factors (LASA, HRM) or for reporting allergies. The improvement of traceability on drug management, roles and responsibilities led to just-in-time updating and sharing.
The integrated development of new alert functions for LASA, HRM and any allergies in the computerised medication chart has provided safer management of drug therapy and is in line with Ministerial Recommendations for safety and quality requirements. This tool was presented to the coordinators and health professionals, through information and training sessions. Learning was challenging but it was immediately recognized as an important tool in significantly reducing the potential risks related to the pharmacological therapeutic process.
Preventable adverse events reside in the process of prescribing and administering drug therapy, especially in intensive care settings. Awareness of this risk we aimed at continuous improvement, together with the rational use of resources, this has led to the optimization of the e-STU whilst maintaining even higher standards of quality and safety of care.