title: Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units.
abstract: OBJECTIVE
  Clinical Pharmacy Services (CPS) are considered standard of care and they are endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).
  
  
  METHODS
  This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.
  
  
  RESULTS
  Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.
  
  
  CONCLUSIONS
  Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.
authors: Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil. Electronic address: lucasokumura@yahoo.com.br.
authors: Lucas Miyake
authors: LM
authors: Okumura
authors: Hospital Infantil Waldemar Monastier, Campo Largo, PR, Brasil.
authors: Daniella Matsubara da
authors: DM
authors: Silva
authors: Hospital Infantil Waldemar Monastier, Campo Largo, PR, Brasil.
authors: Larissa
authors: L
authors: Comarella
mesh_terms: D001938:Brazil; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010607:Pharmacy Service, Hospital; D012189:Retrospective Studies
keywords: Critical care; Cuidados intensivos; Drug‐related side effects and adverse reactions; Efeitos colaterais relacionados a medicamentos e reações adversas; Erros de medicação; Intensive Care Units, Pediatric; Medication errors; Patient safety; Pharmacy Service, Hospital; Segurança do paciente; Serviço de Farmácia, Hospital; Unidades de Cuidado Intensivo Pediátrico