Management of dangerous drugs and their biosecurity measures in the Uruguayan Health
DOI:
https://doi.org/10.35954/SM2019.38.2.3Keywords:
Cytostatic Agents /administration & dosage; Containment of Biohazards; Education, Nursing /statistics & numerical data; Biological Factors /radiation effects, ytostatic Agents /administration & dosage; Containment of Biotatistics & numerical data; Biological Factors /radiation effectsAbstract
Goals: To identify the biosecurity measures adopted and used by the health team and to know the perception of risks and difficulties of the same in the handling of dangerous drugs in the Uruguayan Health System. Method: A mixed study was conducted with health personnel handling dangerous drugs at eight health institutions in the metropolitan area of Montevideo, Uruguay. The quantitative phase was an observational, cross-sectional, exploratory study and the qualitative phase used the focus group technique with content analysis. Of 188 health professionals and technicians from the eight health institutions involved in the management of dangerous drugs, 145 participated in the study, including 76 (52.4%) nursing assistants, 32 (22.1%) nursing graduate, 27 (18.6%) service assistants, eight (5.5%) pharmaceutical chemists and two (1.4%) of pharmacy auxiliaries. It should be noted that of the 145 participants, 71 (49.0%) belonged to public institutions and 74 (51.0%) to private institutions. The collection of quantitative data was performed using a structured and non-participatory observation technique. Focus Group technique was used in order to know the perception of risks and difficulties in the handling of dangerous drugs according to the health personnel. Data were stored and analyzed in Microsoft Office Excel 2007. A descriptive analysis was carried out with relative and absolute frequency of the variables. For qualitative data, thematic analyzes were performed based on previously elaborated categories or inductively from all the responses produced in the group. Results: It was observed that at eight health institutions, public and private, the staff receiving and storing dangerous drugs are indistinct, nursing graduate, pharmaceutical chemists, nursing auxiliaries and / or pharmacy auxiliaries, according to availability and not all staff are performing this task using personal safety equipment. During the preparation of dangerous drugs not all institutions have adequate personal safety equipment, only 12.5% of the Institutions have gowns exclusively designed for chemotherapy, 62.5% have over waterproof robes and a 25, 0% waterproof, regular and fabric. None of the eight institutions have chemotherapy gloves. Preparation of dangerous drugs is carried out in one institution of the pharmaceutical chemists and nursing graduate, in other place is in charge of the pharmacy auxiliaries and in the remaining six are in charge of the graduates in nursing and / or nursing assistants. The administration of dangerous drugs is in charge of nursing graduates and nursing auxiliaries in the total of all institutions participating in this research. Pharmaceutical chemists as a whole comply with all the activities of the different processes in 100.0%. The process of content analysis allowed the generation of three categories: 1. Difficulties in the management of dangerous drugs, 2. Perception of Risks, 3. Achievements in Management of Dangerous Drugs. Through reports, difficulties related to human, material and infrastructure resources could be identified, as well as weaknesses in knowledge, absence of protocols, weaknesses in training, lack of institutional support and absence of a regulatory framework related to management of Dangerous drugs at national level. Staffs who handle dangerous drugs recognize the risks and are aware that they are always present. In the stories, it was verified that the obtained results characterized by self-formation were mostly by personal effort. In terms of material resources and infrastructure, staff has conquered negotiating with institutions over the years. Conclusions: In light of the goals set out in this study, it is concluded that there is no compliance with the recommendations of the international standards. The need of Public Policies in the country with a regulatory framework for all Health Institutions would make possible to change the current situation that was observed and reduce possible risks that health staffs are exposed.
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