[Pharmaceutical procedures in patients under treatment with total parenteral nutrition]

To describe and analyse pharmaceutical care activities, medication errors and/or drug-related problems in patients with total parenteral nutrition.

A prospective study was carried out over a six-month period. All pharmaceutical care activities for patients in treatment with total parenteral nutrition were registered and classified. Daily patient medical and pharmacotherapy chart review plus patient interviews allowed the identification of medication errors and/or drug-related problems associated with both total parenteral nutrition and other pharmacological treatments.

During the study period, 49 patients received total parenteral nutrition. 415 pharmaceutical care activities were carried out, representing a median of 8 pharmaceutical care activities per patient (rank: 4-18). In 33 patients, at least one medication error was detected (n= 63), therefore representing 1 medication error per patient with total parenteral nutrition every 5 days. Most frequent errors were: wrong dose (n= 46, 73%), incorrect treatment duration (n= 9, 14.3%) and wrong drug (n= 5, 7.9%). All these errors originated a potential drug-related problem which affected indication in 50.8% of the cases; safety in 41.3% and effectiveness in 7.9%.

Results obtained during this study show a high demand for pharmaceutical attention in patients with total parenteral nutrition treatment. Identification and classification of medication errors and drug-related problems help to identify system points that can be improved, thus increasing assistential quality.