Protocolisation and centralisation for preparing vasoactive high-alert medications in intensive care units

• Autores: Isabel Cuesta López, Marina Sánchez Cuervo, A. Candela Toha, Juana Benedí González, Teresa Bermejo Vicedo
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 18, Nº. 1, 2016, pág. 2
• Idioma: inglés
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• Resumen

  • Objectives: To protocolise and to centralise the preparation of intravenous mixtures of vasoactive high-alert medications according to the protocols in the Pharmacy Department.

    Method: The study was carried out by a multidisciplinary work team in two phases: 1) Protocolisation and standardisation of intravenous mixtures of vasoactive high-alert and 2) Centralisation of the intravenous mixtures preparation in the Pharmacy Department. The working group selected the drugs for which to establish protocols and standardise the preparations in periodic meetings. Then, the Pharmacy Department designed a prescription-preparation-dispensing-removal circuit for the intravenous mixtures.

    Results: The drugs selected were the following vasoactive drugs: adrenaline, dobutamine, dopamine, nitroglycerin and noradrenaline. The mixtures finally selected in protocols for intravenous administration in pump are: adrenaline 0.016 mg/ml,dobutamine 2 mg/ml, dopamine 2 mg/ml, nitroglycerin 0.2 mg/ml and noradrenaline 0.2 mg/ml. For all 5􀀈 glucose solution was unified as the diluent.

    The protocols were implemented in the hospital Intensive Care Units and later extended to other services.

    For the implementation of the protocols in the ICU, a poster was designed and informative sessions were also held in each of the ICU before the centralisation of the preparation in the Pharmacy Department.

    Physicians had available in the computerised physician order entry system a protocol to prescribe each of the five intravenous mixtures.

    Conclusions: The protocolisation and centralisation of the preparation of highalert medications decrease the variability of the clinical practice in the management of this type of drugs.