Pharmaceutical intervention on peripheral vascular access in a general acute hospital
Keywords:
Peripheral intravenous catheter, Clinical pharmacy, Pharmaceutical intervention, Drug related problemsAbstract
Introduction: It is estimated that up to 80% of hospitalized patients require a peripheral intravenous catheter (PIC). Their placement and permanence is related to infectious and non-infectious complications, and to an increase in hospital stay and associated costs. In our hospital, we perform pharmacotherapeutic follow-up of hospitalized patients and our goal is to optimize the prescriptions, among them, the unnecessary use of parenteral therapy and the medical products that it implies.
Objective: To quantify the pharmaceutical interventions (PI) over the removal of PICs in hospitalized patients under pharmacotherapeutic follow-up, to discriminate whether this intervention was carried out as a consequence of other PI and describing the pharmacological groups involved with them.
Materials and methods: An observational and retrospective trial including hospitalized patients. From the pharmacotherapeutic follow-up forms used for data recording, we selected those with the coded intervention "without clinical rationale" (WCR) related to PICs, also recording whether the PI was given simultaneously with "incorrect route of administration" (IRA), or with "end of treatment" (EOT), over drugs that were being administered intravenously.
Results: There were 2783 patients included. The “WCR” PI on PICs was performed in 512 of the total patients under follow-up, resulting in a PIC withdrawal rate of 18.4%. This withdrawal occurred over a PIC that was not being used for drug administration in 22.7% of the cases and related to the PIs “IRA” or “EOT” in the remaining 77.3%. When the withdrawal of PIC was accompanied by the withdrawal of a drug, these were distributed according to: antimicrobials 40.2%, fluid therapy 36.1%, corticosteroids 16.2%, with the remaining distributed among other pharmacological groups.
Conclusions: PIC withdrawal was run by clinical pharmacists in 18.4% of patients under pharmacotherapeutic follow-up; 77.3% of these withdrawals were associated with the PIs “IRA” or “EOT”, in the majority of the cases, over an antimicrobial drug.
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