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Biomedical subjects

I Font Noguera

Publications and source records attributed to I Font Noguera.

10 recordsLinked to original sources
PubMed1993

[Methods for quality control in parenteral nutrition. III: application of the program to therapeutic results].

Therapeutic results of parenteral nutrition are evaluated by clinical nutritional benefits and by its safety with respect to the potential complications related to the method of administration and its inherent metabolic complications. In this context, a quality control programme was applied retrospectively to 148 patients and was evaluated according to the following indicators: a) PN suspension; b) a nutritional evaluation on termination of the parenteral nutrition; c) catheters inserted; d) mechanical complications; e) septic complications; f) routine controls; g) complete controls, and h) biochemical changes. The compliance percentages obtained were 92.8, 100, 85.1, 81.4, 84.9, 60.0, 33.1 and 43.8 respectively. These results allow us to see, for the first time, the profile of therapeutic quality in patients with parenteral nutrition. Likewise, it constitutes an obligatory methodology of intrahospital reference for continued improvement of parenteral nutrition received by patients admitted to this hospital.

Adolescent↗
PubMedDate not supplied

[Pharmaceutical care self-assessment process for hospitalized patients through the Valor program].

OBJECTIVE: To assess the quality of pharmaceutical care for inpatients using qualitative criteria as established in the Valor program. METHOD: Evaluation study through 43 explicit structural, process, and outcome criteria within the Valor program, in which pharmacists in the Unit Dose Functional Unit may assess themselves along a compliance scale from 0 to 100%. This Unit provides daily individualized pharmaceutical care to 550 patients in an adult general and surgery hospital. Mean scores per pharmacist and item are estimated for the 2003-2005 period. RESULTS: Mean compliance assessments for all 14 interannual "structural items" were 53, 57, and 64%; those for all 13 "process items" were 52, 51, and 46%; and those for all 15 "outcome items" were 18, 28, and 26%. A variability of 20% was documented for structure and process evaluations, and of 50% for outcome assessments. CONCLUSIONS: Every autoevaluation raises to the equipment the necessity to establish improvements and to enhance communication, and the application of standardized procedures in the pharmaceutical care process.

Humans↗
PubMedDate not supplied

[Critical elements for the extension of working hours in an in-hospital Pharmacy Department]

INTRODUCTION: Individualised drug dispensation facilitates compliance with validated prescriptions, the application of criteria for rational use, the prevention and solution of drug-related problems. However, its complexity entails a risk for errors in procedure design and implementation, which renders quality assessment and continual improvement mandatory. OBJECTIVE: To analyse critical elements justifying the extension of working hours in an in-hospital Pharmacy Department, and other improvements within the pharmaco-therapeutic process through activity and hospital care quality indicators. METHODS: This is an observational, analytic study wherein seven activity and quality indicators were established. Regarding the latter, a qualitative and quantitative cause analysis was performed. The study period was from April to June 2001. RESULTS: Monthly average of hospital admissions was 641+/-50; of these, 40% take place during the evening-night hours, and 559+/-197 scheduled surgical procedures were performed. A total of 1,499+/-158 monthly prescriptions were processed, representing 36,790+/-733 doses. Eighteen percent of daily prescriptions were received at 14-15 h, and 21% were offset 24 h with respect to prescription date. During the evening-night period the on-call supervisor visited the Pharmacy 4 times a day to dispense 10 drugs corresponding to 4 patients; 47.7% of cases took place at 15-21 h, patient admissions and pharmacy dispensation errors being the main reason for visits. CONCLUSIONS: Extending the hours of operation in a Pharmacy Department would improve pharmaco-therapeutic patient care, but this should be associated with an integral improvement of doctor and both ward and pharmacy nursing staff work procedures.

Journal Article↗
PubMedDate not supplied

[The methodology of quality control in parenteral nutrition. II. The application of the program to a therapeutic plan].

Patients subjected to parenteral nutrition (PN) must be treated based on a therapeutical plan which has been adapted to their nutritional and clinical needs within a normalizing framework. Furthermore, for this therapeutical plan to be effective and safe, not only must it be suitable for the patient, but also "exact" with regard to daily routines. The quality control programme designed was applied retrospectively to 148 patients. Evaluation was made based on the following indicators: a) delay in initiating parenteral nutrition, b) average intake of macronutrients, c) administration of micronutrients, d) duration of the PN, e) temporary interruptions of the PN, f) errors in medication and g) return of nutrient units. The compliance percentage obtained was 100, 100, 28.7, 89.5, 63.2 100 and 100 respectively. The results obtained have made it possible to understand the quality profile of the therapeutical plan applied to patients on PN. It is also a useful method for the continued improvement of this therapy.

Age Factors↗
PubMedDate not supplied

[Therapeutic interchange of drugs not included in the hospitaĺs pharmacotherapeutic guide: a quality program].

BACKGROUND: Standardised substitution of those drugs not included in the hospitaĺs formulary constitutes one of several methods used to improve therapeutic efficiency, due to reduction of variability in pharmaceutical practice and prevention of potential medication errors. OBJECTIVES: To evaluate quality of drug substitution procedures in those drugs not included in the hospital's formulary. METHODS: Assessment study in a surgical hospital with 314 beds, using structural, process and outcome criteria from 1998 to 2002. RESULTS: Compliance degree for structure, process and outcome criteria were 100, 89 and 35%, respectively, while the established standards were 100%. Prevalence values for patients with substituted medication, increased from 2.9 (95%CI, 2.4-3.6) in 1998 to 11.1% (95%CI, 10.2-12.1) in 2002. Non-substituted drugs annual cost decreased from 20,199 in 1998 to 12,356 Euro in 2002. Drug substitution made by the pharmacist had an acceptance degree of 82.5%. No interchange errors were found in 126 replaced drugs. CONCLUSIONS: The development of quality programs to improve drug prescription adherence to the hospitaĺs formulary, specially those that promote therapeutic interchange under the Pharmacy Committee guidance, are helpful strategies to make a proficient management of patients pharmacotherapy.

Algorithms↗
PubMedDate not supplied

[The methodology of quality control in parenteral nutrition. I. The application of a program in patient selection].

The establishing of indications for parenteral nutrition and the evaluation criteria for the nutritional state of patients used in selecting the candidates for parenteral nutrition are the two main pillars upon which the rationalization of nutritional therapy iv is based. This is an important aspect which conditions the quality of therapeutics. The aim of this study is to apply a quality control programme in the process of selecting candidates for parenteral nutrition. The programme was applied retrospectively to 148 patients. The following parameters were evaluated as quality indicators, based on criteria and standards: "Indications", "Clinical Justification", "Evaluation of the Nutritional State at the commencement of PN", and "Administration of Albumin". The degree of compliance obtained for each of these indicators (100; 87.4; 88.0 and 93.9% respectively) showed no statistically significant difference from the previous standards (100, 80, 80 and 100 respectively). The quality control results obtained have permitted us to select the right candidate for PN, and is a useful tool for improving this therapy through the establishing of new objectives.

Aged↗
PubMedDate not supplied

[Approximation of a proposal of therapeutic criteria for parenteral nutrition].

The care of patients with parenteral nutrition is made up of the care provided by the different members of a multidisciplinary team. This cooperative participation is translated into the establishment and the application of a therapeutic protocol as a frame for the use of parenteral nutrition. It is usual for these protocols to include the normalization of the formulations of parenteral nutrition units, as well as containing logistical processes such as prescription, preparation, dispensation, and administration. Also, the classical review studies on the use of parenteral nutrition aim to know the degree of compliance with the protocols and/or the variability in the application of this therapy. However, this model aims to re-direct itself towards the improvement of the effectiveness and the therapeutic quality obtained in patients treated with parenteral nutrition. The objective of the present study is to present explicit criteria to be included in the parenteral nutrition protocols and the constitute action guidelines for the identification of problems and taking decisions in the resolution and prevention of the same. Also, they are elements for the evaluation of the applied processes and of therapeutic results obtained in patients fed intra-venously.

Evaluation Studies as Topic↗