Atuação do farmacêutico clínico na unidade de terapia intensiva adulto de um hospital universitário

Abstract

The aim of the study was to determine the importance of the pharmacist's inclusion in the Adult Intensive Care Unit of the University Hospital of Santa Maria through the practice of clinical pharmacy. This is a quantitative, descriptive and cross-sectional study, in which the records of pharmaceutical clinical interventions performed after analysis of the prescriptions of 110 patients hospitalized in the adult ICU of the Santa Maria University Hospital. The patients 'profile and prescriptions were obtained through the patients' electronic medical records through the University Hospitals Management Application. Data were collected during routine clinical activities of the resident pharmacist in management and hospital care, from September 2016 to January 2017. During the analysis of the prescriptions there were 671 pharmaceutical interventions. Of 51 interventions related to the route of administration, 88.23% were related to the incorrectly prescribed route of administration. Drug-drug interaction (277 prescriptions) and drug incompatibilities (197 prescriptions) accounted for 72.13% of the interventions. Most of the pharmaceutical interventions were accepted by the health care team. Through Micromedex® tool interactions were classified and reported after the health team responsible. In a total of 1808 interactions 311 different types were identified. Of these, 24 were classified as contraindicated. Among the interactions considered to be of major or moderate severity, the most frequent events were the association between midazolam and fentanyl, followed by omeprazole and midazolam. Regarding the documentation, 71% were reasonable, 23% good and 6% excellent. Only 3% justified not need major interventions, because these were considered secondary interactions. Through the results we can say that the participation of the clinical pharmacist in ICU assists in resolving drug-related problems.The presence of the pharmacist in ICUs provides the formation of a link between the doctor and the nurse, allowing an overview of the whole process of prescription until the administration of the medicine. Thus, the pharmaceutical interventions optimize the pharmacological treatment of hospitalized patients consolidating the importance of clinical pharmacist ICU for increased patient safety.