6533b820fe1ef96bd127a081

RESEARCH PRODUCT

Measurement of continuous improvement in the safety of oncologic patients

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Objetivo: Analizar la mejora continua en la seguridad del paciente oncológico, a través de la evolución de los indicadores de calidad establecidos tras la implantación de un sistema de gestión de la calidad (SGC) según norma ISO 9001:2008, en una unidad de oncología farmacéutica (UOF). Método: Estudio observacional prospectivo realizado entre Enero 2008 y Diciembre de 2011. La certificación ISO 90012008 de la UOF incluyó los procesos de prescripción electrónica, validación, preparación, dispensación y administración del tratamiento antineoplásico. Se establecieron los indicadores de calidad: errores de medicación (EM) de preparación y dispensación que no alcanzan al paciente, y EM que alcanzan al paciente. Los indicadores se calcularon con una periodicidad trimestral a partir del aplicativo informático Farmis-Oncofarm®, se definió el estándar de cumplimiento en 0,05). Conclusiones: El seguimiento de los indicadores de calidad permite medir y evaluar la seguridad farmacoterapéutica en el paciente oncológico. Tras la implantación del SGC en la UOF se han reducido los EM generados. Objective: To analyze continuous improvement in the safety of oncologic patients through the change of quality indicators established with the implementation of a quality management system (QMS) according to the ISO 9001-2008 regulation at a oncologic pharmacy unit (OPU). Method: Prospective and observational study carried out between January of 2008 and December of 2011. The ISO 9001-2008 certification of the OPU included the proceedings of electronic prescription, validation, preparation, delivery, and administration of the antineoplastic therapy. The following quality indicators were established: medication errors (ME), preparation and delivery errors not reaching the patient, and ME reaching the patient. The indicators were calculated quarterly through the Farmis-Oncofarm® software; the adherence standard was defined at < 1 ME per one thousand and the follow-up was done through control graphs. One "postimplementation" period (2008-2011) and one "pre-implementation" period (2007) were established and the U Mann Whitney test was used to compare the median of the indicator for both periods. The differences between the two periods were considered to be statistically significant when the p value was p < 0.05. Results: 140,440 preparations were made at the OPU, for 4,770 patients, corresponding to 52,906 patients-day. The adherence to the standard during the first one-year period allowed reducing the three indicators to < 0,5 ME per one thousand. For preparation ME an abnormal value was identified; the causes were analyzed and improvement measures were proposed. In the post-implementation period, ME were reduced during the post-implementation period as compared to the pre-implementation period (p<0.05). Conclusions: The follow-up of the quality indicators allows measuring and assessing the pharmacotherapy safety in the oncologic patient. After the implementation of the QMS at the OPU, the number of ME has been reduced.