Full text
| |
| Author(s): |
Eliane Ribeiro
Total Authors: 1
|
| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Conjunto das Químicas (IQ e FCF) (CQ/DBDCQ) |
| Defense date: | 2002-03-07 |
| Examining board members: |
Antonio Carlos Zanini;
Kazuko Uchikawa Graziano;
Paulo Andrade Lotufo;
Milton de Arruda Martins;
Valentina Porta
|
| Advisor: | Antonio Carlos Zanini; Julio Litvoc |
| Abstract | |
OBJECTIVE: to analyze medical adherence to the tool \"Special Form for Albumin Request\" designed by the hospital directory, containing nonrestrictive, technical guidance information and its impact on albumin prescription for parenteral administration at the hospital for a one-year period. MATERIALS AND METHODS: we analyzed all documents prescribed by the doctors in the institution, as handwritten prescription or specially printed form, used for requesting and dispensing human albumin to the Division of Pharmacy during the period of October 1st 1998 to September 30th 1999. To help the analysis, the forms were divided in \"ADEQUATE\" or \"INADEQUATE\", according to their coherence to the data shown in the instrument. RESULTS: we analyzed 3,457 documents, being 3,341 as the instrument distributed by the hospital and 112 as handwritten prescriptions, physician\'s order sheet and printed forms; 77% of the filled-in instruments displayed at least one empty field; around 50% of the instruments were considered \"INADEQUATE\" concerning the clinical practice guidelines; 11 clinics were responsible for around 64% of the total number of forms used, and 6 of these had at least 50% of their requests labeled \"INADEQUATE\". The most frequently filled-in information was \"Decompensated Chronic Disease\" (especially paracentesis, liver failure and cirrhosis). The prescribers who presented the lowest CRM numbers were the ones to show the best adherence to the clinical practice guidelines. The analysis of the number of albumin vials dispensed by the Central Pharmacy per 100 patients-day showed a statistically significant difference between the means obtained in the anterior and posterior period of protocol introduction and that the linear component of the series corresponding to the period of June 1997 to September 1999, presented a negative and statistically significant correlation coefficient. Several variables can account for such a decrease, besides the implementation of the laboratory and clinical practice guidelines: the standardization of hetastarch, the delay in process of purchase, lack of the product and the form and scientific media. CONCLUSION: The doctors adherence to the protocol was not considered satisfactory, although there was a decrease in albumin vials dispensed after its introduction. However, the protocol implementation allowed the identification of selected groups to concentrate educational interventions. (AU) | |