• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.22.2020.tde-20032020-145503
Document
Author
Full name
Josy Maria Maximiano Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Gabriel, Carmen Silvia (President)
Lima, Silvana Andrea Molina
Pereira, Leonardo Régis Leira
Sousa, Fernanda Raphael Escobar Gimenes de
Title in Portuguese
Análise dos potenciais eventos adversos e reações adversas a medicamentos em Hospital de Minas Gerais: estudo exploratório sobre os fatores contribuintes
Keywords in Portuguese
Evento adverso
Hospitais
Incidentes relacionados a medicamentos
Reações adversas a medicamentos
Abstract in Portuguese
Eventos adversos (EA) são definidos como lesão ou dano não intencional que resulta em incapacidade ou disfunção, temporária ou permanente, e/ou prolongamento do tempo de permanência hospitalar ou morte em decorrência do cuidado em saúde prestado. Dentre eles estão os incidentes relacionados a medicamentos. Diante da escassez de conhecimento epidemiológico sobre os EA no país, este estudo propôs analisar os incidentes relacionados a medicamentose os potenciais eventos adversos (pEA) registrados em prontuários de internação de adultos em hospital geral do Estado de Minas Gerais, no ano de 2015. Metodologicamente foram utilizados instrumentos de coleta para verificar a ocorrência de pEA e reação advesa medicamentosa (RAM) baseados no Canadian Adverse Events Study:Tracking Form. Foram realizadas análises descritivas considerando grupos de variáveis: características do paciente, dados da admissão, fatores intrínsecos e extrínsecos e critérios de rastreamento de pEA. As análises consistiram em avaliar as frequências absoluta e relativa dos fatores indicados pelo instrumento de coleta. Para a análise das possíveis correlações e associações com pEA e RAM, foram realizados testes de correlação de Spearman, Qui-quadrado e Teste Exato de Fisher, respectivamente. Para a identificação de possíveis preditores de pEA foram realizados Testes de Regressão Logística. Em todos os testes foram adotados nível de significância de e α=0,05 e intervalo de confiança de 95%.Os fatores: orientação do farmacêutico, reconciliação medicamentosa e ordem fonada fornecida pelos médicos foram analisadas descritivamente. Os resultados mostraram correlação positiva entre idade e dias de internação e associação entre pEA e o atendimento via SUS e o tipo de internação eletiva. Houve evidência de associação entre pEA e os fatores intrínsecos: diabetes, insuficiência cardíaca, hipertensão arterial e história de alcoolismo e os extrínsecos:sonda urinária fechada, cateter arterial, cateter venoso central, nutrição enteral, sonda nasogástrica, ventilação mecânica e bomba de infusão.Os resultados mostraram, ainda, associação significativa entre pEA e RAM.A regressão logística apontou que os preditores: atendimento (SUS), caráter eletivo, idade, tempo de internação, hipertensão arterial, diabetes, uso de nutrição enteral, sonda nasogátrica e ventilação mecânica aumentam a chance de pEA. Concluiu-se que as RAM estão associadas ao pEA e que as características dos pacientes (idade) associadas a fatores intrínsecos e extrínsecos, tipo de convênio e caráter de internação podem potencializar a ocorrência de EA em ambiente hospitalar.
Title in English
Analysis of potential adverse events and adverse drug reactions at Hospital de Minas Gerais: exploratory study on contributing factors
Keywords in English
Adverse drug reactions
Adverse event
Drug related incidents
Hospital
Abstract in English
Adverse events (AE) are defined as unintentional injury or damage not wonted that results in incapacity or dysfunction temporary or permanent disability, and / or extendimy temp of hospital story or death as a result of health care provided. Among them, are the incidents related to medicines, facing the lock of epidemiological. Epidemiological knowledge about AE in the country, this study got proposed to analyze the incidents related to the medicines and potencial adverse events scored in adults and potential adverse events (pAE) recorded in adult hospitalization records in a general hospital in the state of Minas Gerais in the year of 2015, in 2015.It was used Methodologically, instruments to verify the occurrence of Potencial adverse event (pEA) and adverse drug reaction (ADR) by the the Canadian Adverse Events Study: Tracking Form. Descriptive analyzes were accomplished considering groups of variables: features of patient, admission data, intrinsic and extrinsic factors, and pEA screening criteria. The analyzes consisted of evaluating the absolute and relative frequencies of the factors indicated by the collects instrument. For the analysis of possible correlations and associations with pEA and RAM, were accomplisheb tests of Spearman's correlation tests, Chi-square and Fisher's exact tests were performed, respectively. To identify possible predictors of pEA, Logistic Regression Tests were accomplished tests of logistic regression. All over the tests, were adapted level of meaning of α= 0.05 and a confidence interval of 95%. The results have shown positive correlation between age and hospitalization doy and between association between pEA and the treatment by SUS, elective type. were adopted. The factors: pharmacist guidance, drug reconciliation, and phoned order provided by physicians were analyzed descriptively. The results showed a positive correlation between age and days of hospitalization and association between ASD and SUS care and the type of elective hospitalization. There was evidence of an association between pEA and intrinsic factors: diabetes, heart failure, hypertension and history of alcoholism and extrinsic factors: closed urinary tube, arterial catheter, central venous catheter, enteral nutrition, nasogastric tube, mechanical ventilation and infusion pump. The results also showed a significant association between pEA and RAM. The logistic regression indicated that the predictors: attendance (SUS), elective character, age, length of stay, hypertension, diabetes, use of enteral nutrition, nasogastric tube and mechanical ventilation increase the chance of pEA. It was concluded that ADRs are associated with ASP and that patient characteristics (age) associated with intrinsic and extrinsic factors, type of agreement and hospitalization character may potentiate the occurrence of AE in a hospital environment.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2020-05-12
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.