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Advisor(s)
Abstract(s)
Este relatório surge no âmbito da unidade curricular "Estágio" inserida no Mestrado
Integrado em Ciências Farmacêuticas da Universidade da Beira Interior (Covilhã),
fazendo parte integrante do plano de estudos relativo ao 2º semestre do 5º ano. Este
trabalho encontra-se estruturado em três capítulos e refere-se ao culminar de todo um
período de aprendizagem e atividades desenvolvidas nos estágios de farmácia
hospitalar e comunitária, bem como um trabalho de investigação no âmbito da
farmácia hospitalar e que pretende estudar o problema da devolução de medicamentos
em diversos serviços de internamento com dose individual diária e unidose, face ao
aumento crescente das devoluções nesses serviços e encontrar possíveis soluções tendo
em vista uma necessária redução dos custos e desperdícios.
O primeiro capítulo refere-se à componente de investigação, que foi desenvolvida nos
Serviços Farmacêuticos do Hospital Sousa Martins, pertencente à Unidade Local de
Saúde da Guarda visando a análise das devoluções de medicamentos em dose
individual unitária e unidose em vários serviços de internamento.
A gestão dos serviços farmacêuticos hospitalares é sem dúvida um dos grandes desafios
e competências dos farmacêuticos hospitalares, responsáveis pela qualidade, eficácia e
segurança dos medicamentos. Dessa forma e embora a implementação dos sistemas de
distribuição individualizada para os serviços de internamento hospitalar seja uma
intervenção farmacêutica que ajuda a racionalizar a distribuição dos medicamentos,
diminuir os erros relacionados com a medicação e racionalizar os custos com a
terapêutica, não deixam de existir problemas com as devoluções dos medicamentos
distribuídos desta forma.
Este problema desde algum tempo que acompanha a realidade dos serviços
farmacêuticos e se tem tornado cada vez mais acentuado nos últimos anos, dessa forma
e numa época de constantes constrangimentos orçamentais e em que a saúde e o
serviço nacional de saúde se encontra subfinanciado, surgiu a possibilidade de se fazer
este estudo de análise e controlo dos desperdícios com medicamentos durante um
período de nove meses (setembro de 2018 a maio de 2019), pretendendo-se identificar
os serviços mais relevantes em volume de devoluções, qual o tipo de devolução
/desperdício mais significativo, quais as formas farmacêuticas mais devolvidas e reutilização de fármacos ou inutilizações como desperdício através de um registo e
análise da informação recolhida diariamente de todos os medicamentos devolvidos pelo
processo de distribuição em dose unitária provenientes dos vários serviços de
internamento.
Este estudo tem também como objetivos promover uma discussão multidisciplinar para
o problema, definindo um conjunto de medidas práticas, as quais visam melhorar
comportamentos, procedimentos e atitudes com todos os profissionais de saúde que
manuseiam/utilizam medicamentos, para que os serviços adotem uma postura
proactiva na sua prática diária de modo a se poder utilizar com segurança a medicação
devolvida conseguindo obter uma redução de custos mantendo o circuito do
medicamento hospitalar.
O segundo capítulo deste relatório refere-se à experiência em farmácia hospitalar,
realizada nos Serviços Farmacêuticos do Centro Hospitalar Universitário Cova da
Beira, no período compreendido entre setembro e novembro de 2018, sob orientação
da Dra. Olímpia Fonseca, pretendendo dar enfase às principais áreas de atuação do
farmacêutico bem como os aspetos legais inerentes à farmácia hospitalar.
O terceiro e último capítulo deste relatório aborda a componente de estágio em
farmácia comunitária, o qual decorreu na Farmácia da Sé, na Guarda, sob a orientação
da Dra. Maria João Grilo e Dra. Cláudia Gomes. Este estágio foi realizado entre
novembro de 2018 e janeiro de 2019, perfazendo um total de 800 horas. Neste capítulo
são descritas as diversas responsabilidades e atividades atribuídas ao farmacêutico em
contexto comunitário, bem como algumas particularidades relacionadas com o
enquadramento legal e financeiro desta vertente.
Neste relatório estão também presentes os vários trabalhos apresentados em
congressos e conferências e que pretenderam dar a conhecer novas perspetivas e
abordagens deste tema.
This report is part of the curricular unit "Internship" inserted in the Integrated Master in Pharmaceutical Sciences of the University of Beira Interior (Covilhã), being part of the study plan for the 2nd semester of the 5th year. This work is structured in three chapters and refers to the culmination of a whole period of learning and specialized activities in the internships of hospital and community pharmacy, as well as a research work in the hospital pharmacy that intends to study the problem of the medication waste disposal in several inpatient services with single daily dose and single dose, in view of the increasing number of medication in these services and possibly find solutions towered a necessary reduction of costs and waste. The first chapter refers to the research component, which was developed at the Pharmaceutical Services of Hospital Sousa Martins, at the Local Health Unit in Guarda, Portugal, aiming at the analysis of the medication returned to the pharmaceutical services in individual unit doses in various clinical and inpatient services. The management of hospital pharmaceutical services is undoubtedly one of the major challenges and competencies of hospital pharmacists, whom are responsible for the quality, efficacy and safety of drugs. Thus, while the implementation of individualized distribution systems for inpatient services is a pharmaceutical intervention that helps rationalize drug distribution, decrease medication errors, and decrease therapy costs. However, there are still problem with the returns of drugs distributed in this way. This has been constant problem in the reality of pharmaceutical services for some time and has become more and more relevant in recent years. Thus, at a time of constant budget constraints and in which health and the national health service becoming underfunded. The possibility of this type of analysis on drug control waste over a period of ten months (September 2018 to June 2019). Could identify the volume of returns, what type of return / waste are more significant, what are the representative disposed pharmaceutical forms and drug reuse or disposal as waste by recording and analyzing the daily information collected from all drugs returned through the unit dose delivery process from the various inpatient services. This study also aims to promote a multidisciplinary discussion of the problem, defining a set of practical measures, which aim to improve behaviors, procedures and attitudes between all health professionals responsible for handing use drugs, thus adopting a proactive stance in their daily practice in order for safety use of returned drugs and achieving cost savings while maintaining the hospital medication circuit. The second chapter of this report refers to the experience in hospital pharmacy, carried out at the Pharmaceutical Services of the Cova da Beira University Hospital Center, between September and November 2018, under the guidance of Dr. Olímpia Fonseca, which intended to focus on the main work areas or skills pharmacist have as well as the legal aspects intrinsic to the hospital pharmacy practice. The third and final chapter of this report deals with the internship component in community pharmacy, which was held at the Sé pharmacy in Guarda, Portugal under the guidance of Dr. Maria João Grilo and Dr. Cláudia Gomes, this internship was held between November the 2018 and January 2019, accounting for a total of 800 hours. This chapter describes the various responsibilities and activities assigned to the pharmacist in the community context, as well as some particularities related to the legal and financial framework of this aspect. This report also presents the various works presented at congresses and interviews and which aim to discover new perspectives and approaches to this theme.
This report is part of the curricular unit "Internship" inserted in the Integrated Master in Pharmaceutical Sciences of the University of Beira Interior (Covilhã), being part of the study plan for the 2nd semester of the 5th year. This work is structured in three chapters and refers to the culmination of a whole period of learning and specialized activities in the internships of hospital and community pharmacy, as well as a research work in the hospital pharmacy that intends to study the problem of the medication waste disposal in several inpatient services with single daily dose and single dose, in view of the increasing number of medication in these services and possibly find solutions towered a necessary reduction of costs and waste. The first chapter refers to the research component, which was developed at the Pharmaceutical Services of Hospital Sousa Martins, at the Local Health Unit in Guarda, Portugal, aiming at the analysis of the medication returned to the pharmaceutical services in individual unit doses in various clinical and inpatient services. The management of hospital pharmaceutical services is undoubtedly one of the major challenges and competencies of hospital pharmacists, whom are responsible for the quality, efficacy and safety of drugs. Thus, while the implementation of individualized distribution systems for inpatient services is a pharmaceutical intervention that helps rationalize drug distribution, decrease medication errors, and decrease therapy costs. However, there are still problem with the returns of drugs distributed in this way. This has been constant problem in the reality of pharmaceutical services for some time and has become more and more relevant in recent years. Thus, at a time of constant budget constraints and in which health and the national health service becoming underfunded. The possibility of this type of analysis on drug control waste over a period of ten months (September 2018 to June 2019). Could identify the volume of returns, what type of return / waste are more significant, what are the representative disposed pharmaceutical forms and drug reuse or disposal as waste by recording and analyzing the daily information collected from all drugs returned through the unit dose delivery process from the various inpatient services. This study also aims to promote a multidisciplinary discussion of the problem, defining a set of practical measures, which aim to improve behaviors, procedures and attitudes between all health professionals responsible for handing use drugs, thus adopting a proactive stance in their daily practice in order for safety use of returned drugs and achieving cost savings while maintaining the hospital medication circuit. The second chapter of this report refers to the experience in hospital pharmacy, carried out at the Pharmaceutical Services of the Cova da Beira University Hospital Center, between September and November 2018, under the guidance of Dr. Olímpia Fonseca, which intended to focus on the main work areas or skills pharmacist have as well as the legal aspects intrinsic to the hospital pharmacy practice. The third and final chapter of this report deals with the internship component in community pharmacy, which was held at the Sé pharmacy in Guarda, Portugal under the guidance of Dr. Maria João Grilo and Dr. Cláudia Gomes, this internship was held between November the 2018 and January 2019, accounting for a total of 800 hours. This chapter describes the various responsibilities and activities assigned to the pharmacist in the community context, as well as some particularities related to the legal and financial framework of this aspect. This report also presents the various works presented at congresses and interviews and which aim to discover new perspectives and approaches to this theme.
Description
Keywords
Desperdício de Medicamentos Devolução de Medicamentos Estratégias de Redução de Desperdício Com Medicamentos Farmácia Comunitária Farmácia Hospitalar