[Pre-post evaluation of the implementation of safe practices for high-risk medications in a second-level hospital]

A high percentage of medication errors are preventable; therefore, institutions are constantly striving to try to reduce them. When errors occur with high-risk medications, the possibility of causing serious harm to the patient increases, making the implementation of safe practices essential to try to avoid them. The main objective of the study was to establish in a second-level hospital, and especially in Pediatrics, practices for the safe management of these drugs at all stages of their handling.

The study was developed in three phases: pre-intervention, intervention and post-intervention. The implementation was quantitatively evaluated with process indicators and with items from the Hospital Medication Utilization System Safety Self-Assessment Questionnaire; the results obtained were validated by statistical analysis, using Chi-square test of homogeneity, Fisher's exact test, chi-square goodness of fit test, Shapiro-Wilk test, and Student's t-test.

Actions were implemented to allow a safer management of high-risk medications, such as creating a defined list in the hospital, eliminating unnecessary presentations, avoiding isoappearance, identifying them correctly, including alerts, among others. After implementation, the stipulated quantitative indicators improved in a statistically significant manner, demonstrating a relevant impact of the interventions performed. The median percentage improvement for the expected frequencies of indicator 3 was 83.77%. All items evaluated in the Self-Assessment Questionnaire improved.

This implementation serves to improve the management of high-risk medications in the hospital, increasing the safety of the processes. It can serve as a basis for other hospitals that need to add interventions to improve patient safety.