SEGURANÇA NA PRESCRIÇÃO E USO DE MEDICAÇÃO EM UNIDADE DE TERAPIA INTENSIVA

Abstract

Intensive care units are at high risk due to the complexity of care, multiple invasive procedures and the use of multiple medicines. This research sought to analyze the safety of the prescription and use of medicines in an adult intensive care unit. This was a documental, non-participant and quantitative observation study, held in an adult intensive care unit of a public teaching hospital in the Mid-West of Brazil, with data collected between October and November 2024, on different days and shifts. The medical records of hospitalized patients were analyzed, and the data were compared with bedside observation of the devices in use and infusions in progress. A clinical characterization and setting instrument, developed by the researcher, which underwent content validation, and the Medication Prescription Safety Checklist instruments were used to analyze adherence to recommendations for safe medication prescription, and the Critical Nursing Situation Index was used to identify unsafe nursing situations involving medicines. Data were submitted to descriptive and inferential statistics. The study was approved by the Research Ethics Committee under CAAE: 81410024.0.0000.0320. A total of 147 observations were made of patients, with a mean age of 62 years (SD ≅ 13.06; maximum 87; minimum 26), clinical (n=119) and surgical (n=28) hospitalizations. The analysis of the prescription revealed an overall adherence rate of 73.89%, with emphasis on the standardization of the nomenclature of medicines (99.24%) and the correct use of punctuation (96.37%) and weaknesses in the use of vague expressions for the duration of treatment (26.11%) and the definition of the infusion rate (11.66%). Regarding the critical nursing situations, significant flaws were identified in the documentation, such as the absence of a record of the fluids used in all types of precaution (p-value