[A project for the implementation of a unit-dose drug dispensation system in an intensive care unit].
OBJECTIVE
To describe the implementation of a unitary dose drug dispensation system (UDDDS) with computerized medical orders in an intensive care unit (ICU) including 10 multi-purpose offices, and to obtain a medication error index as an indicator of the process quality.


METHODS
A UDDDS with computerized medical orders for intensive care was defined. By consensus among nurses, intensivists and pharmacists, the administration of high-risk drugs by perfusion or through a gastric tube was protocolized, and computerized medical orders were adapted to ICU dynamics, with both fluid therapy and enteral and parenteral nutrition becoming fully integrated. A prospective observational 8-month study with 15 cross-sectional time points was performed to estimate the overall error index and mean error per drug use process stage. The error index is estimated by dividing the number of errors into error opportunities, and is expressed as a percentage.


RESULTS
Computerized medical orders favored compliance with consensus protocols defined in software programs at the pharmacy department, even though the degree of adhesion degree was not quantitized. They also allowed a validation of all medical prescriptions by a pharmacist before dispensation. The total number of errors detected during the study period was 86. Error opportunities were 26,695, and the overall error index was 0.32%. During the study an error occurred every 312.5 error opportunities.
Valenzuela Gámez
J C
JC
Servicio de Farmacia, C.H. La Mancha-Centro, Alcázar de San Juan, Ciudad Real. jcarlosv@sescam.jccm.es
López González
A M
AM
Pedraza Cezón
L A
LA
Andrés Navarro
N
N
González Manzanares
J L
JL
D007362:Intensive Care Units; D050316:Medical Order Entry Systems; D008508:Medication Errors / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D011446:Prospective Studies