Identificación de los resultados negativos asociados a la medicación relacionados a la nutrición parenteral en el área de neonatología del Hospital Gineco Obstétrico Isidro Ayora

Abstract

The purpose of the research was to identify the negative results associated with medication, related to Parenteral Nutrition in the neonatology area at Isidro Ayora obstetrician gyneco Hospital in Quito, during the period January - April 2021, through a prospective, descriptive, observational study; reviewing medical records, nursing logs, clinical examination reports, Parenteral Nutrition prescriptions (PNs) and databases in pharmacy area. Information from 78 infants who met the inclusion criteria. It was classified based on the type of Drug-Related Problem (DRPs) as a possible cause of Negative Results Medication-Associated (NRMs) found by administrative, physical- chemical and clinical validation. The probable NRMs found were classified by criteria of need, effectiveness and safety according to the Third Consensus of Granada. Microsoft Excel 2016 was used to estimate frequencies, percentages and SPSS-Statistics 25, for measures of association, Relative Risk (RR) and multivariate statistical significance analysis. A sample was obtained with a predominance of males (51%), preterm patients (87%) and low birth weight (40%), who were prescribed 920 PNs. The PRMs were 78.81% by physicochemical validation, 17.62% clinical and 3.57% administrative. The possible NRMs were 72% due to quantitative insecurity, need as an untreated health problem (16%) and quantitative ineffectiveness (11%). Statistical association (p less than 0.05) was found between "Lipid rate greater than necessary" - "cholestasis" (RR 3.2; 95% CI 1.720-6.109), and "carbohydrates greater than necessary" - "hyperglycemia" (RR 2.8; 95% CI 1.203-6.430). The NMRs associated with PRMs were statistically related to gestational age, Apgar score, PN time and number of administered drugs. The creation of a Nutritional Therapy Committee was proposed as a strategy. It is recommended to evaluate clinical markers related to PN such as magnesium, phosphorus, and Ureic Nitrogen in Blood.