[Study of parenteral iron use in a health facility and its impact in terms of hospital economics]

INTRODUCTION

Administration of parenteral iron is a mainstay of iron deficiency treatment. Evaluation and control of this element is an issue for healthcare facilities. Study of parenteral iron use is thus to be evaluated in its impact in terms of hospital economics.

MATERIALS AND METHODS

Parenteral iron administrations that took place on 2014 in our healthcare facility were retrospectively identified by pharmacists. Following data were extracted from Pharma™ and Crossway™ softwares: indication, diagnostic coding and total dose of iron received. They were then compared to the summary of product characteristics.

RESULTS

Of 198 analyzed prescriptions, iron deficiency was known or suspected for 97% of patients. However, the total dose of iron administered was not in compliance for three quarters of prescriptions. Sixty-eight percent of patients appear under-dosed. Administration's traceability was found for two-thirds. Eighty-five hospital discharges did not have the right coding and 34 stays were charged like an external act instead sessions. Financial loss for the hospital is estimated at 49,300 euros.

DISCUSSION AND CONCLUSION

As part of improving practice, close pharmaceutical monitoring of parenteral iron prescribed dosing regimen is essential. Effective communication with the medical information department and regular awareness raising of prescribers should also allow to give more value to this act. Hospital economics is a real tool to aid decision-making.

[Nasal administration of fentanyl: prevention of medication-related errors by using REMED-method]

REMED stands for a "MEDication Errors Review". The REMED method aims at implementing and monitoring actions to improve patient medical care. This approach is part of the continuing healthcare quality and safety improvement and professional practice evaluation. REMED uses methodology and tools. Thus we use this methodology in the context of a drug errorwhich occurred in the dermatology department of our hospital. After this event description, related to a sensitive drug product, Instanyl (transmucosal fentanyl), the drug error is described, then the different causes are analyzed. These last are numerous and occur at any stage of patient medical care. They must allow us to show actions in order to improve patients' safety.